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Laparoscopic versus conventional Nissen fundoplication: the influence on plasma insulin-like growth factor-I and
C Sietses1, M J Wiezer, P A van Leeuwen
1Department of Surgery, Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Background:
Conventional surgery is known to influence postoperative insulin-like growth factor-I (IGF-I) levels and to increase protein breakdown. Recent animal data described that laparoscopic surgery, in contrast to conventional surgery, maintains postoperative IGF-I levels, suggesting a reduced postoperative catabolic response.
Aim:
The aim of this study was to demonstrate differences in the postoperative catabolic response between laparoscopic and conventional surgery.
Methods:
Seventeen patients scheduled for Nissen fundoplication were randomly assigned to undergo either a laparoscopic or a conventional procedure. The catabolic response was assessed by measuring total IGF-I and insulin-like growth factor binding protein-3 (IGFBP-3).
Results:
IGF-I levels decreased significantly 4 days after both types of surgery. IGFBP-3 decreased more rapidly after conventional surgery than after the laparoscopic technique; however, the differences between the groups were not significant.
Conclusion:
In contrast to animal data, no differences in plasma IGF-I or IGFBP-3 were seen in patients undergoing laparoscopic or conventional Nissen fundoplication.
