A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy |
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Authors: | Renato A. Luna Daniel B. Nogueira Pablo S. Varela Eduardo de O. Rodrigues Neto Maria Júlia R. Norton Luciana do Carmo B. Ribeiro Agatha M. Peixoto Yara L. de Mendonça Isidro Bendet Rossano A. Fiorelli James P. Dolan |
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Affiliation: | 1. Second Clinics of General Surgery, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil 2. Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239-3098, USA 4. Universidade Federal do Estado do Rio de Janeiro—UNIRIO Medical School, Rio de Janeiro, Brazil 3. Immunology section of the Sergio Franco Laboratory, Rio de Janeiro, Brazil
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Abstract: | Background The purpose of this study was to compare the postoperative inflammatory response and severity of pain between single-incision laparoscopic surgery (SILS) cholecystectomy and conventional laparoscopic cholecystectomy (LC). Methods Two groups of 20 patients were prospectively randomized to either conventional LC or SILS cholecystectomy. Serum interleukin-6 (IL-6) levels were assayed before surgery, at 4–6 h, and at 18–24 h after the procedure. Serum C-reactive protein (CRP) levels also were assayed at 18–24 h after surgery. Pain was measured at each of three time points after surgery using the visual analogue scale (VAS). The number of analgesia doses administered in the first 24 h after the procedure also was recorded and 30-day surgical outcomes were documented. Results The groups had equivalent body mass index (BMI), age, and comorbidity distribution. Peak IL-6 levels occurred 4–6 h after surgery, and the median level was 12.8 pg/ml in the LC and 8.9 pg/ml in the SILS group (p = 0.5). The median CRP level before discharge was 1.6 mg/dl in the LC and 1.9 mg/dl in the SILS group (p = 0.38). There was no difference in either analgesic use or pain intensity as measured by the VAS between the two groups (p = 0.72). The length of the surgical procedure was significantly longer in the SILS group (p < 0.001). No intraoperative complications occurred in either group. Conclusions Single-incision laparoscopic surgery does not significantly reduce systemic inflammatory response, postoperative pain, or analgesic use compared with LC. |
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