Date: 10 Feb 2011
Evaluating Systemic Stress Response in Single Port vs. Multi-Port Laparoscopic Cholecystectomy
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Background and Aims
Acute-phase proteins and inflammatory cytokines mediate measurable responses to surgical trauma, which are proportional to the extent of tissue injury and correlate with post-operative outcome. By comparing systemic stress following multi-port (LC) and single-incision laparoscopic cholecystectomy (SILC), we aim to determine whether reduced incision size induces a reduced stress response.
Thirty-five consecutive patients were included, 11 underwent SILC (mean ± SEM; age 44.8 ± 3.88 year; BMI 27 ± 1.44 kg/m2) and 24 underwent LC (56.17 ± 2.80 year; 31.72 ± 1.07 kg/m2, p < 0.05). Primary endpoint measures included levels of interleukin-6 and C-reactive protein measured pre- and post-operatively. Length-of-stay (LOS) and postoperative morbidity were secondary endpoints.
No statistically significant differences were found between SILC and LC for interleukin-6 and C-reactive protein levels, LOS and duration of surgery. There was also no correlation between systemic stress response and operative parameters. There were no intra-operative complications.
SILC appears to be a safe, feasible technique with potential advantages of cosmesis, reduced incisional pain, and well-being recommending its use. These data indicate no difference in systemic stress and morbidity between SILC and LC. A larger, multi-centred, randomised prospective trial is warranted to further investigate and confirm this finding.
Presented at London Surgical Symposium, 9th September 2010, London and Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI) Annual Scientific Meeting 2010, 25th–26th November, Nottingham, UK.
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- Evaluating Systemic Stress Response in Single Port vs. Multi-Port Laparoscopic Cholecystectomy
Journal of Gastrointestinal Surgery
Volume 15, Issue 4 , pp 614-622
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- Acute phase response
- Single incision laparoscopic surgery (SILS)
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- Author Affiliations
- 1. Department of Biosurgery and Surgical Technology, Imperial College London, Academic Surgical Unit, St Mary’s Hospital, Paddington, UK
- 3. Department of Biosurgery and Surgical Technology, Division of Surgery, Academic Surgical Unit, Imperial College London, 10th Floor QEQM, St Mary’s Hospital, London, W2 1NY, UK
- 2. Division of Infectious Diseases, Department of Medicine, Imperial College London, Norfolk Place, London, W2 1PG, UK