Minimal increase in gut-mucosal interleukin-6 during laparoscopy

Abstract

Background: The gut clearly plays a significant role in postoperative recovery. Other investigators have shown an increase in gut-mucosal cytokines in septicemia and burn models. We tested the effects of laparotomy and laparoscopy on gut-mucosal IL-6 production.

Methods: A/J mice were randomized to three groups: control, laparotomy plus bowel manipulation (OBM), and laparoscopy plus bowel manipulation (LBM). Serum and gut-mucosal samples obtained at 4 and 8 h after surgery were analyzed for IL-6.

Results: We found that OBM is associated with increased serum and gut-mucosal IL-6 at both 4 and 8 h after surgery. In contrast, LBM showed a blunted response in serum IL-6 and no change in gut-mucosal IL-6 at both time intervals.

Conclusions: We conclude that laparoscopy minimizes trauma to the peritoneal environment, thereby decreasing the gut's inflammatory response to operation. This differential response of the gut may partially explain the preservation of gut function following laparoscopy.