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Metabolic responses after laparoscopic or open hernia repair
P Schrenk1, P Bettelheim, R Woisetschläger
1Second Department of Surgery and Ludwig Boltzmann Institute for Surgical Laparoscopy, AKH Linz, Krankenhausstrasse 9, A-4020 Linz, Austria.
Background:
The purpose of a prospective randomized study was to compare the surgical trauma in patients undergoing laparoscopic or open hernia repair.
Methods:
Postoperative pain, analgesic consumption, and metabolic response to surgery were assessed in 30 patients undergoing laparoscopic (group 1; n = 15) or open (group II; n = 15; Shouldice repair) unilateral inguinal hernia repair. Both groups were comparable with respect to age, sex, and type and size of inguinal hernia.
Results:
Postoperative visual analogue scales (VAS) for pain were reduced on mobilization for patients of group I with a significant difference (P = 0.02) on the operative day, whereas pain scores at rest and analgesic requirements were similar for both groups. No differences between groups I and II were found in postoperative levels of interleukin-1, interleukin-6, tumor necrosis factor alpha, C-reactive protein, fibrinogen, transferrin, alpha-1-antitrypsin, and white blood cells. Postoperative polymorphonuclear (PMN) elastase concentrations remained within normal range in group II but showed a significant increase in patients operated laparoscopically for postoperative days 1 and 2.
Conclusions:
No major surgical trauma was found after herniorraphy compared to open hernia repair.