Evaluating Systemic Stress Response in Single Port vs. Multi-Port Laparoscopic Cholecystectomy

Autor: Ara Darzi, Sanjay Purkayastha, Paraskevas Paraskeva, Victoria J. Wright, Alec Aslanyan, Mikael H. Sodergren, Colleen McGregor
Rok vydání: 2011
Předmět:
Zdroj: Journal of Gastrointestinal Surgery. 15:614-622
ISSN: 1873-4626
1091-255X
DOI: 10.1007/s11605-011-1432-y
Popis: Acute-phase proteins and inflammatory cytokines mediate measurable responses to surgical trauma, which are proportional to the extent of tissue injury and correlate with post-operative outcome. By comparing systemic stress following multi-port (LC) and single-incision laparoscopic cholecystectomy (SILC), we aim to determine whether reduced incision size induces a reduced stress response.Thirty-five consecutive patients were included, 11 underwent SILC (mean ± SEM; age 44.8 ± 3.88 year; BMI 27 ± 1.44 kg/m(2)) and 24 underwent LC (56.17 ± 2.80 year; 31.72 ± 1.07 kg/m(2), p 0.05). Primary endpoint measures included levels of interleukin-6 and C-reactive protein measured pre- and post-operatively. Length-of-stay (LOS) and postoperative morbidity were secondary endpoints.No statistically significant differences were found between SILC and LC for interleukin-6 and C-reactive protein levels, LOS and duration of surgery. There was also no correlation between systemic stress response and operative parameters. There were no intra-operative complications.SILC appears to be a safe, feasible technique with potential advantages of cosmesis, reduced incisional pain, and well-being recommending its use. These data indicate no difference in systemic stress and morbidity between SILC and LC. A larger, multi-centred, randomised prospective trial is warranted to further investigate and confirm this finding.
Databáze: OpenAIRE
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