A prospective case-control study of the local and systemic cytokine response after laparoscopic versus open colonic surgery

dc.contributor.authorSammour, T.
dc.contributor.authorKahokehr, A.
dc.contributor.authorZargar-Shoshtari, K.
dc.contributor.authorHill, A.
dc.date.issued2012
dc.description.abstractBACKGROUND: There is a sequential, high concentration cytokine response after major abdominal surgery. The magnitude of this response has been directly linked to postoperative metabolic derangement, ileus, adhesions, and oncological outcomes. We aimed to compare the local and systemic cytokine response in laparoscopic and open colonic surgery and relate this to postoperative recovery parameters. METHODS: Using a prospectively collected patient database, we compared a Study Group (n = 50) of patients undergoing elective laparoscopic colonic resection with a Control Group (n = 25) of patients undergoing equivalent open colonic surgery within an ERAS program. Patients were matched for age, gender, BMI, ASA, Cr Possum, side of resection, diagnosis, and histologic stage. Plasma and peritoneal fluid concentrations of IL-6, IL-8, IL-10, and TNFα were measured at 20-24 h after surgery. The Surgical Recovery Score was determined pre-operatively and at 3, 7, 30, and 60 d postoperatively. All data were prospectively collected, and a priori definitions were used for discharge parameters, complications, and complication severity. RESULTS: Peritoneal fluid IL-6 concentration was lower after laparoscopic surgery. There were no significant differences in the other cytokines measured, or in any postoperative recovery outcomes. Significant correlations were found between cytokine levels and discharge criteria achievement, day stay, postoperative complications, and the Surgical Recovery Score. CONCLUSION: With the exception of a lower peritoneal IL-6 level, the systemic and peritoneal cytokine response at 20-24 h is similar after laparoscopic versus open colonic resection within an ERAS program, with corresponding equivalent rates of postoperative recovery.
dc.description.statementofresponsibilityTarik Sammour, Arman Kahokehr, Kamran Zargar-Shoshtari and Andrew G. Hill
dc.identifier.citationJournal of Surgical Research, 2012; 173(2):278-285
dc.identifier.doi10.1016/j.jss.2010.10.009
dc.identifier.issn0022-4804
dc.identifier.issn1095-8673
dc.identifier.orcidSammour, T. [0000-0002-4918-8871]
dc.identifier.urihttp://hdl.handle.net/2440/106535
dc.language.isoen
dc.publisherElsevier
dc.rights© 2012 Elsevier Inc. All rights reserved.
dc.source.urihttps://doi.org/10.1016/j.jss.2010.10.009
dc.subjectCytokine; laparoscopy; colectomy; interleukin; pneumoperitoneum; colon
dc.titleA prospective case-control study of the local and systemic cytokine response after laparoscopic versus open colonic surgery
dc.typeJournal article
pubs.publication-statusPublished

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