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Inflammatory and tumor stimulating responses after laparoscopic sigmoidectomy.

Kim JS, Hur H, Min BS, Lee KY, Chung HC, Kim NK - Yonsei Med. J. (2011)

Bottom Line: However, objective evidence of its immunologic and oncologic benefits is scarce.Clinical parameters and serum markers were compared.However, there were no significant differences in the preoperative and postoperative levels of CRP, IL-6, VEGF, and IGFBP-3 between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.

ABSTRACT

Purpose: Laparoscopic colectomy has clinical benefits such as short hospital stay, less postoperative pain, and early return of bowel function. However, objective evidence of its immunologic and oncologic benefits is scarce. We compared functional recovery after open versus laparoscopic sigmoidectomy and investigated the effect of open versus laparoscopic surgery on acute inflammation as well as tumor stimulation.

Materials and methods: A total of 57 patients who were diagnosed with sigmoid colon cancer were randomized for elective conventional or laparoscopically assisted sigmoidectomy. Serum samples were obtained preoperatively and on postoperative day 1. C-reactive protein (CRP) and interleukin-6 (IL-6) were measured as inflammation markers, and vascular endothelial growth factor (VEGF) and insulin-like growth factor binding protein-3 (IGFBP-3) were used as tumor stimulation factors. Clinical parameters and serum markers were compared.

Results: Postoperative hospital stay (p=0.031), the first day of gas out (p=0.016), and the first day of soft diet (p<0.001) were significantly shorter for the laparoscopic surgery group than the open surgery group. The levels of CRP, IL-6, and VEGF rose significantly, and the concentration of IGFBP-3 fell significantly after both open and laparoscopic surgery. However, there were no significant differences in the preoperative and postoperative levels of CRP, IL-6, VEGF, and IGFBP-3 between the two groups.

Conclusion: Our data suggest that both open and laparoscopic surgeries are accompanied by significant changes in IL-6, CRP, IGFBP-3, and VEGF levels. Acute inflammation markers and tumor stimulating factors may not reflect clinical benefits of laparoscopic surgery.

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Related in: MedlinePlus

A postoperative decrease of insulin-like growth factor binding protein-3 (IGFBP-3) correlated with a concentration of the first postoperative day (POD1) interleukin-6 (r=0.354, p=0.007). The ratio between the values of preoperative (Preop) versus the POD1 IGFBP-3 was used to analyze for a postoperative loss of the protein.
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Figure 7: A postoperative decrease of insulin-like growth factor binding protein-3 (IGFBP-3) correlated with a concentration of the first postoperative day (POD1) interleukin-6 (r=0.354, p=0.007). The ratio between the values of preoperative (Preop) versus the POD1 IGFBP-3 was used to analyze for a postoperative loss of the protein.

Mentions: There was a significant correlation between the POD1 IL-6 level and a drop in VEGF which was calculated as a ratio between POD1/preoperative VEGF (r=0.293; p=0.027) (Fig. 6). In addition, a drop in IGFBP-3 calculated as a ratio between preoperative/POD1 IGFBP-3 also had significant correlation with POD1 IL-6 (r=0.354; p=0.007) (Fig. 7).


Inflammatory and tumor stimulating responses after laparoscopic sigmoidectomy.

Kim JS, Hur H, Min BS, Lee KY, Chung HC, Kim NK - Yonsei Med. J. (2011)

A postoperative decrease of insulin-like growth factor binding protein-3 (IGFBP-3) correlated with a concentration of the first postoperative day (POD1) interleukin-6 (r=0.354, p=0.007). The ratio between the values of preoperative (Preop) versus the POD1 IGFBP-3 was used to analyze for a postoperative loss of the protein.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104449&req=5

Figure 7: A postoperative decrease of insulin-like growth factor binding protein-3 (IGFBP-3) correlated with a concentration of the first postoperative day (POD1) interleukin-6 (r=0.354, p=0.007). The ratio between the values of preoperative (Preop) versus the POD1 IGFBP-3 was used to analyze for a postoperative loss of the protein.
Mentions: There was a significant correlation between the POD1 IL-6 level and a drop in VEGF which was calculated as a ratio between POD1/preoperative VEGF (r=0.293; p=0.027) (Fig. 6). In addition, a drop in IGFBP-3 calculated as a ratio between preoperative/POD1 IGFBP-3 also had significant correlation with POD1 IL-6 (r=0.354; p=0.007) (Fig. 7).

Bottom Line: However, objective evidence of its immunologic and oncologic benefits is scarce.Clinical parameters and serum markers were compared.However, there were no significant differences in the preoperative and postoperative levels of CRP, IL-6, VEGF, and IGFBP-3 between the two groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.

ABSTRACT

Purpose: Laparoscopic colectomy has clinical benefits such as short hospital stay, less postoperative pain, and early return of bowel function. However, objective evidence of its immunologic and oncologic benefits is scarce. We compared functional recovery after open versus laparoscopic sigmoidectomy and investigated the effect of open versus laparoscopic surgery on acute inflammation as well as tumor stimulation.

Materials and methods: A total of 57 patients who were diagnosed with sigmoid colon cancer were randomized for elective conventional or laparoscopically assisted sigmoidectomy. Serum samples were obtained preoperatively and on postoperative day 1. C-reactive protein (CRP) and interleukin-6 (IL-6) were measured as inflammation markers, and vascular endothelial growth factor (VEGF) and insulin-like growth factor binding protein-3 (IGFBP-3) were used as tumor stimulation factors. Clinical parameters and serum markers were compared.

Results: Postoperative hospital stay (p=0.031), the first day of gas out (p=0.016), and the first day of soft diet (p<0.001) were significantly shorter for the laparoscopic surgery group than the open surgery group. The levels of CRP, IL-6, and VEGF rose significantly, and the concentration of IGFBP-3 fell significantly after both open and laparoscopic surgery. However, there were no significant differences in the preoperative and postoperative levels of CRP, IL-6, VEGF, and IGFBP-3 between the two groups.

Conclusion: Our data suggest that both open and laparoscopic surgeries are accompanied by significant changes in IL-6, CRP, IGFBP-3, and VEGF levels. Acute inflammation markers and tumor stimulating factors may not reflect clinical benefits of laparoscopic surgery.

Show MeSH
Related in: MedlinePlus