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Comparison of inflammatory responses following robotic and open colorectal surgery: a prospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Robotic colorectal surgery continues to rise in popularity, but there remains little evidence on the stress response following the procedure. The aim of this study was to evaluate the inflammatory response to robotic colorectal surgery and compare it with the response generated by open colorectal surgery.

Methods

This was a prospective nonrandomized comparative study involving 61 patients with colorectal cancer. The evaluation of inflammatory response to either robotic or open colorectal surgery was expressed as changes in interleukin-1β, interleukin-1 receptor antagonist, interleukin-6, tumor necrosis factor-α, C-reactive protein, and procalcitonin during the first three postoperative days.

Results

Of the 61 patients, 33 underwent robotic colorectal surgery while 28 had open colorectal surgery. Groups were comparable with respect to age, sex, BMI, cancer stage, and type of resection. The relative increase of interleukin-1 receptor antagonist at 8 h postoperative, compared to baseline, was higher in the open group (P = 0.006). The decrease of interleukin-1 receptor antagonist on postoperative days 1 and 3, compared to the maximum at 8 h, was more pronounced in the open group than in the robotic group (P = 0.008, P = 0.006, respectively), and the relative increase of interleukin-6 at 8 h after incision was higher in the open group (P = 0.007). The relative increase of procalcitonin on postoperative days 1 and 3 was higher in the open group than the robotic group (P < 0.001, P = 0.004, respectively).

Conclusions

This study shows that when compared with open colorectal surgery, robotic colorectal surgery results in a less pronounced inflammatory response and more pronounced anti-inflammatory action.

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Acknowledgments

This study was part of the project entitled “Wrovasc—Integrated Cardiovascular Centre,” co­financed by the European Regional Development Fund, as part of the Innovative Economy Operational Program, 2007–2013. It took place at Regional Specialist Hospital, Research and Development Centre in Wroclaw, Poland.

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Authors and Affiliations

  1. Department of Surgical Oncology, Regional Specialist Hospital, Research and Development Centre at Regional Specialist Hospital, ul. Kamienskiego 73a, 51-124, Wroclaw, Poland

    Marek Zawadzki & Wojciech Witkiewicz

  2. Department of Medical Biochemistry, Wroclaw Medical University, ul. Chalubinskiego 10, 50-368, Wroclaw, Poland

    Malgorzata Krzystek-Korpacka & Andrzej Gamian

  3. Laboratory of Medical Microbiology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland

    Andrzej Gamian

Authors
  1. Marek Zawadzki
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  2. Malgorzata Krzystek-Korpacka
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  3. Andrzej Gamian
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  4. Wojciech Witkiewicz
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Corresponding authors

Correspondence to Marek Zawadzki or Malgorzata Krzystek-Korpacka.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Author Marek Zawadzki and author Malgorzata Krzystek-Korpacka contributed equally to the presented work

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Zawadzki, M., Krzystek-Korpacka, M., Gamian, A. et al. Comparison of inflammatory responses following robotic and open colorectal surgery: a prospective study. Int J Colorectal Dis 32, 399–407 (2017). https://doi.org/10.1007/s00384-016-2697-0

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  • DOI: https://doi.org/10.1007/s00384-016-2697-0

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