Inflammatory response in laparoscopic vs. open surgery for gastric cancer
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Inflammatory response in laparoscopic vs. open surgery for gastric cancer. / Okholm, Cecilie; Goetze, Jens Peter; Svendsen, Lars Bo; Achiam, Michael Patrick.
I: Scandinavian Journal of Gastroenterology, Bind 49, Nr. 9, 09.2014, s. 1027-1034.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Inflammatory response in laparoscopic vs. open surgery for gastric cancer
AU - Okholm, Cecilie
AU - Goetze, Jens Peter
AU - Svendsen, Lars Bo
AU - Achiam, Michael Patrick
PY - 2014/9
Y1 - 2014/9
N2 - OBJECTIVE: Laparoscopic surgery may offer advantages compared to open surgery, such as earlier mobilization, less pain and lower post-surgical morbidity. Surgical stress is thought to be associated with the postoperative immunological changes in the body as an impaired immune function, which may lead to an increased susceptibility to complications and morbidity. The aim of this review was to investigate if laparoscopic surgery reduces the immunological response compared to open surgery in gastric cancer.METHODS: We conducted a literature search identifying relevant studies comparing laparoscopy or laparoscopic-assisted surgery with open gastric surgery. The main outcome was postoperative immunological status defined as surgical stress parameters, including inflammatory cytokines and blood parameters.RESULTS: We identified seven studies that addressed the immunological status in patients undergoing laparoscopic or laparoscopy-assisted surgery compared to open surgery. IL-6 in circulation was found to be significantly reduced in laparoscopic patients. Furthermore, the plasma concentration of C-reactive protein was significantly lower in laparoscopic patients compared to patients undergoing laparotomy. Finally, most studies reported lower levels of white blood cell count in laparoscopic patients, although this result did not reach statistical significance in a small number of studies.CONCLUSIONS: Laparoscopy-assisted gastric surgery seems to attenuate the immune response compared to open surgery. Larger and prospective studies are needed to further evaluate if the immunological status is relatively preserved in minimal invasive surgery and if this may reduce the postoperative complications compared to open surgery.
AB - OBJECTIVE: Laparoscopic surgery may offer advantages compared to open surgery, such as earlier mobilization, less pain and lower post-surgical morbidity. Surgical stress is thought to be associated with the postoperative immunological changes in the body as an impaired immune function, which may lead to an increased susceptibility to complications and morbidity. The aim of this review was to investigate if laparoscopic surgery reduces the immunological response compared to open surgery in gastric cancer.METHODS: We conducted a literature search identifying relevant studies comparing laparoscopy or laparoscopic-assisted surgery with open gastric surgery. The main outcome was postoperative immunological status defined as surgical stress parameters, including inflammatory cytokines and blood parameters.RESULTS: We identified seven studies that addressed the immunological status in patients undergoing laparoscopic or laparoscopy-assisted surgery compared to open surgery. IL-6 in circulation was found to be significantly reduced in laparoscopic patients. Furthermore, the plasma concentration of C-reactive protein was significantly lower in laparoscopic patients compared to patients undergoing laparotomy. Finally, most studies reported lower levels of white blood cell count in laparoscopic patients, although this result did not reach statistical significance in a small number of studies.CONCLUSIONS: Laparoscopy-assisted gastric surgery seems to attenuate the immune response compared to open surgery. Larger and prospective studies are needed to further evaluate if the immunological status is relatively preserved in minimal invasive surgery and if this may reduce the postoperative complications compared to open surgery.
KW - C-Reactive Protein
KW - Gastrectomy
KW - Humans
KW - Immune System Processes
KW - Inflammation
KW - Interleukin-6
KW - Laparoscopy
KW - Leukocyte Count
KW - Stomach Neoplasms
U2 - 10.3109/00365521.2014.917698
DO - 10.3109/00365521.2014.917698
M3 - Review
C2 - 24852697
VL - 49
SP - 1027
EP - 1034
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
SN - 0036-5521
IS - 9
ER -
ID: 138378939