Thyroxine as a Parameter of Stress during Minimally Invasive Surgery

Area of Science:

• General Surgery
• Endocrinology
• Minimally Invasive Surgery

Background:

• The hormonal stress response during surgery is not fully understood.
• Thyroid hormone thyroxine (T4) can serve as a marker for surgical stress.

Purpose of the Study:

• To evaluate the hormonal stress response, specifically T4 levels, during laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC).
• To compare the effects of standard (12-15 mmHg) versus low (6-8 mmHg) intra-abdominal pressure during LC on hormonal stress.

Main Methods:

• A cohort observational study involving 110 patients.
• Patients were divided into OC (40 patients) and LC (70 patients) groups.
• LC patients were further divided into subgroups based on intra-abdominal pressure (standard vs. low).
• Thyroxine (T4) levels were monitored as a stress indicator.

Main Results:

• Open cholecystectomy (OC) resulted in significantly higher postoperative T4 levels compared to LC.
• The overall stress response was less intense in LC compared to OC.
• LC performed with low intra-abdominal pressure showed a lower stress response than with standard pressure.

Conclusions:

• Minimally invasive surgery (LC) offers hormonal advantages over open surgery (OC).
• Utilizing low intra-abdominal pressure during LC further minimizes the body's stress response compared to standard pressure.