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Comparison of surgical stress response to laparoscopic and open radical cystectomy

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Abstract

Objectives

To prospectively compare stress response to laparoscopic and open radical cystectomy by the measurement of humoral mediators and the incidence of systemic inflammatory response syndrome (SIRS).

Methods

Thirty-eight patients undergoing radical cystectomy were prospectively assessed. Blood samples were obtained from all patients before surgery, during surgery, 72 h after surgery. Serum levels of interleukin (IL)-6 and interferon (IFN)-γ were measured using an enzyme-linked immunosorbent assay. We also investigated the incidence and duration of SIRS in the two groups.

Results

The two groups had comparable perioperative variables except for less estimated blood loss in the laparoscopic group. The IL-6 levels increased during and after surgery in the two groups (P < 0.001). However, the IL-6 levels in the laparoscopic group were significantly lower than those in the open group during and after surgery (P = 0.006, P < 0.001). The incidence of SIRS was 57.1% in the laparoscopic group and 79.2% in the open group (P = 0.149). The mean duration of SIRS was 1.4 days in the laparoscopic group and 2.8 days in the open group (P = 0.032). The IFN-γ levels decreased, but there was no difference in the two groups over the entire period assessed. Multivariate analysis demonstrated that the group (laparoscopic versus open) was the only influencing factor on the levels of IL-6 and the duration of SIRS.

Conclusions

Our study suggests that the laparoscopic group is markedly less stressful and it has a shorter duration of SIRS than the open group.

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Abbreviations

LRC:

Laparoscopic radical cystectomy

ORC:

Open radical cystectomy

SIRS:

Systemic inflammatory response syndrome

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Conflict of interest statement

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work. There was no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, China

    Sheng-zheng Wang

  2. Department of Urology, The First Affiliated Hospital, Sun Yat-Sen University, ZhongShan 2nd Road, 58#, 510080, Guangzhou, China

    Yu Chen, Huan-yi Lin & Ling-wu Chen

Authors
  1. Sheng-zheng Wang
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  2. Yu Chen
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  3. Huan-yi Lin
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  4. Ling-wu Chen
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Correspondence to Ling-wu Chen.

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Wang, Sz., Chen, Y., Lin, Hy. et al. Comparison of surgical stress response to laparoscopic and open radical cystectomy. World J Urol 28, 451–455 (2010). https://doi.org/10.1007/s00345-010-0571-1

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  • DOI: https://doi.org/10.1007/s00345-010-0571-1

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