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Inflammatory response after open and laparoscopic Nissen fundoplication in children: a randomized study

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Pediatric Surgery International Aims and scope Submit manuscript

Purpose

It is assumed that laparoscopic surgery generally induces less inflammatory responses than open surgery. Since few studies have compared immune responses after laparoscopic and open surgery in children, we examined inflammatory markers in children randomized to open (ONF) or laparoscopic Nissen fundoplication (LNF).

Methods

Blood samples were collected prior to surgery (D0), and on postoperative day 1 (D1) and day 2 (D2). Inflammatory markers were measured using a multiplex antibody bead kit. The postoperative levels of inflammatory markers were statistically analyzed using a linear mixed model. A P value <0.05 was considered statistically significant.

Results

Twenty-nine patients randomized to ONF or LNF were included. Median age was 3.1 years (range 1.0–14.2) in the ONF group and 4.0 years (range 0.2–14.2) in the LNF group. Plasma levels of the anti-inflammatory cytokine interleukin (IL)-10 were significantly higher in the ONF group than in the LNF group postoperatively (P = 0.04). However, there were no significant differences between the groups in the levels of pro-inflammatory markers tumor necrosis factor-α, IL-6, IL-8, monocyte chemoattractant protein-1, white blood cell count, or C-reactive protein.

Conclusions

We did not find that laparoscopy induced a substantially less inflammatory response than laparotomy in children undergoing fundoplication.

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Acknowledgments

The authors wish to thank Professor Ansgar O Aasen, Institute of Surgical Research, Oslo University Hospital Oslo, Rikshospitalet, for kindly providing laboratory facilities and helping with manuscript preparation. We would also like to thank Solveig Pettersen and Grethe Dyrhaug for their valuable assistance in the laboratory, and all the participating children and their parents. CK Knatten has received financial support from the University of Oslo, the Department of Pediatric Surgery and the Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds. CHB Hviid has received financial support from the Institute of Surgical Research.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Oslo, 0316, Oslo, Norway

    Charlotte Kristensen Knatten, Claus H. B. Hviid, Ragnhild Emblem & Kristin Bjørnland

  2. Department of Pediatric Surgery, Oslo University Hospital HF Rikshospitalet, Nydalen, Post box 4950, 0424, Oslo, Norway

    Charlotte Kristensen Knatten, Ragnhild Emblem & Kristin Bjørnland

  3. Institute for Surgical Research, Oslo University Hospital Rikshospitalet, 0424, Oslo, Norway

    Claus H. B. Hviid

  4. Unit of Biostatistics and Epidemiology, Oslo University Hospital Ullevål, 0424, Oslo, Norway

    Are H. Pripp

Authors
  1. Charlotte Kristensen Knatten
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  2. Claus H. B. Hviid
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  3. Are H. Pripp
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  4. Ragnhild Emblem
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Corresponding author

Correspondence to Charlotte Kristensen Knatten.

Additional information

C. K. Knatten and C. H. B. Hviid have contributed equally to this work and share first authorship.

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Knatten, C.K., Hviid, C.H.B., Pripp, A.H. et al. Inflammatory response after open and laparoscopic Nissen fundoplication in children: a randomized study. Pediatr Surg Int 30, 11–17 (2014). https://doi.org/10.1007/s00383-013-3433-2

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  • DOI: https://doi.org/10.1007/s00383-013-3433-2

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