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Inflammation in laparoendoscopic single-site surgery versus laparoscopic cholecystectomy
Fernando Athayde Veloso Madureira1, José Eduardo Ferreira Manso2, Delta Madureira Filho3
1Universidade Federal do Estado do Rio de Janeiro-UNIRIO, Rio de Janeiro, Brazil drfmadureira@hotmail.com.
Surgical Innovation
|August 16, 2013
Summary
Laparoendoscopic single-site surgery (LESS) may offer a lower inflammatory response and less pain compared to traditional laparoscopic cholecystectomy (LC). This study compared the inflammatory markers of both procedures in patients undergoing gallbladder removal.
Area of Science:
- Minimally Invasive Surgery
- Surgical Inflammation
- Gastrointestinal Surgery
Background:
- Laparoendoscopic single-site surgery (LESS) involves a single umbilical incision for multiple instruments.
- Classic video laparoscopic cholecystectomy (LC) is a standard surgical procedure for gallbladder removal.
Purpose of the Study:
- To compare the inflammatory impact of LESS cholecystectomy versus classic LC.
- To evaluate postoperative pain and inflammatory markers between the two surgical approaches.
Main Methods:
- A prospective randomized controlled study included 57 patients undergoing cholecystectomy.
- Patients were assigned to either LC (n=29) or LESS (n=28).
- Interleukin-6 (IL-6) and C-reactive protein (CRP) levels were measured preoperatively and at 3 and 24 hours postoperatively.
Main Results:
- Median IL-6 levels were significantly lower at 3 hours postoperatively in the LESS group (11.6 pg/mL) compared to the LC group (28.05 pg/mL; P = .029).
- No significant difference in IL-6 levels was observed at 24 hours postoperatively (P = .52).
- Median CRP levels showed no significant difference between the groups at any time point.
Conclusions:
- LESS cholecystectomy, despite a larger incision, showed a tendency toward a lower early inflammatory impact compared to LC.
- A trend towards reduced postoperative pain was observed with LESS cholecystectomy.
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