Systemic Inflammatory Response after Laparoscopic and Open Application of Adjustable Banding for Morbidly Obese Patients |
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Authors: | Kagan Zengin MD Mustafa Taskin MD Nevin Sakoglu MD Ziya Salihoglu MD Sener Demiroluk MD Hafize Uzun MD |
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Institution: | (1) Department of General Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey;(2) Department of General Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey;(3) Department of General Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey;(4) Department of Anaesthesiology Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey;(5) Department of Anaesthesiology Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey;(6) Department of Biochemistry, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey |
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Abstract: | Background: Surgical injury induces a systemic inflammatory metabolic-endocrine response that is proportional to the severity
of the surgical stress. Compared with the conventional open method, laparoscopic surgery is mini-invasive and has decreased
postoperative pain and length of hospitalization. The aim of this study was to investigate the systemic inflammatory response,
after laparoscopic and open stoma-adjustable silicone band application, which is thought to be mediated by cytokines. Method:
30 morbidly obese patients underwent Swedish adjustable gastric banding (SAGB). 15 patients underwent laparoscopic (group
1) and 15 open SAGB (group 2). Mean operative time for the laparoscopic group was 70-110 min and for the laparotomy group
80-120 min. Gallbladders were not removed,and there were no systemic diseases in the patients.The intensity of surgical trauma
was evaluated by measurement of metabolic and hormonal responses to the surgery. Plasma levels of C-reactive (CRP), haptoglobin,
ceruloplasmin, albumin, transferrin, IL-6, malonic dialdehyde (MDA) and creatinine were measured before and after the operation.
Results: CRP and IL-6 levels increased during and after laparoscopic and open SAGB. However, postoperative responses were
significantly greater after open SAGB (group 2) (p<0.05). MDA level, an indicator of an oxidative trauma, was elevated in
group 1 at the 6th postoperative hour but was significantly higher in group 2 at the 6th and 12th postoperative hours. The
results were more significant in group 2 (p<0.05).There was no statistical difference between groups 1 and 2 in terms of albumin,
creatinine, and transferrin levels before and after surgery. Conclusion: The systemic inflammatory res ponses after laparoscopic
SAGB were significantly reduced compared with those after open SAGB. |
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Keywords: | MORBID OBESITY INFLAMMATORY RESPONSE LAPAROSCOPY LAPAROTOMY GASTRIC BANDING |
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