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Published on: February 28, 2025

Surgical stress after open and transumbilical laparoscopic-assisted appendectomy in children

Angela Simona Montalto, Angela Simona1, Pietro Impellizzeri

  • 1Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|February 28, 2013
PubMed

Insights

Transumbilical laparoscopic-assisted appendectomy (TULAA) in children shows a reduced surgical stress response. This minimally invasive approach results in lower postoperative cytokine levels compared to open appendectomy.

Area of Science:

  • Pediatric Surgery
  • Surgical Immunology
  • Minimally Invasive Surgery

Background:

  • The surgical stress response in children undergoing transumbilical laparoscopic-assisted appendectomy (TULAA) remains understudied.
  • Investigating TULAA's impact on surgical stress is crucial for pediatric surgical practice.

Purpose of the Study:

  • To evaluate the surgical stress response in children undergoing TULAA compared to open appendectomy (OA).
  • To analyze the levels of key inflammatory cytokines post-surgery in both TULAA and OA groups.

Main Methods:

  • A comparative study involving 35 children who underwent either OA or TULAA.
  • Measurement of Interleukin-6 (IL-6), IL-18, and IL-10 levels at multiple time points: pre-surgery, intra-surgery, and 24 hours post-surgery.

Main Results:

  • Open appendectomy (OA) led to increased IL-6 and IL-18 levels post-surgery.
  • TULAA also showed an increase in IL-6 and IL-18 at 24 hours, but significantly lower than OA.
  • Specific cytokine levels: IL-6 (11.6 ± 4.4 pg/mL vs. 31.9 ± 8.9 pg/mL, p=0.0006) and IL-18 (145.6 pg/mL vs. 174.9 pg/mL, p=NS) were lower in the TULAA group.

Conclusions:

  • TULAA demonstrates a reduced postoperative cytokine response in children compared to OA.
  • This suggests that TULAA inflicts less surgical trauma in pediatric appendectomy patients.
  • TULAA may be a preferred surgical approach for minimizing stress in pediatric appendectomies.
Abstract

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