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.
- 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