Thyroxine as a Parameter of Stress during Minimally Invasive Surgery

The body's hormonal response to stress during minimally invasive surgery has not yet been completely researched in all its aspects, so the aim of this study was to test the body's hormonal response by monitoring the thyroid hormone thyroxine (T4) during laparoscopic cholecystectomy (LC) using standard (12-15 mm/Hg) and low (6-8 mm/Hg) intraabdominal pressure, and in open cholecystectomy (OC).

This cohort, observational study was conducted in the period from July 2022 to December 2024 and included 110 patients divided into 2 groups: 70 patients who underwent LC, and 40 patients who underwent OC. The first group of patients were divided into 2 subgroups of 35 patients each on the basis of the level of intraabdominal pressure during cholecystectomy (LC with standard, or LC with low intraabdominal pressure). T4 was monitored as the parameter of stress.

The comparison between the LC and OC groups in terms of the concentrations of T4 in the postoperative days showed statistically significant higher values of this hormone in the group of patients treated using the open method (OC). Moreover, the body's response to stress was less intense during LC than during OC. The body's response to stress during LC with low insufflation pressure (6-8 mmHg) was lower than during LC with standard insufflation pressure (12-15 mmHg).

This study confirms from hormonal aspects the advantages of minimally invasive surgery in comparison with open surgery, and in particular the advantages of LC with low intraabdominal pressure in comparison with standard pressure.