Evaluation of systemic inflammatory responses in cholecystectomy by means of access. Single-port umbilical incision, transvaginal NOTES, laparoscopy and laparotomy

Júnior, Elesiário Marques Caetano; Vieira, Josiel Paiva; Moura-Franco, Rita Maria Aparecida; Fuziy, Rogério Aoki; Serra, Humberto Oliveira; Marcondes, Giulianna B.; Shiraiwa, Daniel Kitayama; Sousa, Marcelo Gonçalves; Girão, Manoel Joâo Batista Castello; Filho, Gaspar de Jesus Lopes; Linhares, Marcelo Moura

doi:10.1590/s0102-86502015010000000

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…Laparoscopic hysterectomy is a good technique, and compared with other accesses, this technique has the same advantages of the vaginal approach, which is associated with a low inflammatory response, better hemostasis [23][24][25] . The biggest challenge has been the identification of a balance between reducing surgical trauma and ensuring viability.…”

Section: ■ Discussionmentioning

confidence: 99%

“…However, both procedures had similar results. Singleport laparoscopic surgery is thought to be associated with less incidence of infections, epigastric vessel trauma, postoperative pain and incisional hernias than multiport laparoscopy [20][21][22][23][24][25][26] . Additionally, this approach allows an easier removal of the surgical specimen 24 .…”

Section: Secondary Outcomesmentioning

confidence: 99%

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A prospective randomized study of the inflammatory responses to multiport and singleport laparoscopic hysterectomies

Tormena

Ribeiro²,

Soares³

et al. 2017

Acta Cir. Bras.

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A prospective randomized study of the inflammatory responses to multiport and singleport laparoscopic hysterectomies 1 AbstractPurpose: To evaluate the inflammatory responses induced by laparoscopic hysterectomies with multiport and singleport approaches.Methods: This was a pilot prospective randomized study that included 42 women candidates for hysterectomy at School of Medicine, Hospital das Clínicas, USP. The patients were randomized to two groups: MP-TLH (total laparoscopic hysterectomy with 3 abdominal incisions), and SP-TLH (total laparoscopic hysterectomy with a single umbilical incision). We evaluated the inflammatory response (via CRP, IL-6, IL-10, TNFα, VEGF and leukogram assessments), surgical time, postoperative pain, blood loss and surgical complications in both groups. Results: Both techniques were similar regarding C-reactive protein (p=.666), IL-6 (p=.833), IL-10 (p=.420), TNF-α(p=.098), VEGF (p=.092) and the leukogram (p=.712) measures. The operative time was significantly longer in the SP-TLH group than in the MP-TLH group (p=.001). The pain evaluation was similar in both groups (p=.170). Hemoglobin variation and the aspirated blood volume were similar in both groups (p=.493 and p=.347). There were no major complications. Conclusions: Multiport and singleport laparoscopic approaches are both safe methods for hysterectomy. Although SP-TLH resulted in a significantly longer operative time than MP-TLH, no differences were observed between the groups in inflammatory responses, blood loss and postoperative pain.

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Section: ■ Discussionmentioning

confidence: 99%

Section: Secondary Outcomesmentioning

confidence: 99%

A prospective randomized study of the inflammatory responses to multiport and singleport laparoscopic hysterectomies

Tormena

Ribeiro²,

Soares³

et al. 2017

Acta Cir. Bras.

View full text Add to dashboard Cite

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“…Compared with traditional surgical methods, MIS has the following advantages: [6][7][8] less bleeding during surgery, less suffering, lower incidence rate of complications etc. Laparoscopic cholecystectomy, one of the most common surgeries in clinical practice, is usually performed under the condition of general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Application of PRVC in laparoscopic surgery

Duan¹,

Huang

Hao

et al. 2017

DCC

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Objective: To discuss the clinical significance and value of PRVC by monitoring, comparing and studying pressure control (PC), volume control (VC) and pressure-regulated volume control (PRVC) ventilation modes during pneumoperitoneum. Methods: Ninety patients with laparoscopic cholecystectomy were randomly and equally divided into 3 groups (PC group, VC group and PRVC group). Esophageal pressure (PES), mean airway pressure (PAWM), peak airway pressure (PAP), arterial blood carbon dioxide partial pressure (PaCO2), end-tidal carbon dioxide concentration in the expired air (ETCO2), tidal volume (TV), mean arterial pressure (MAP) and heart rate (HR) were not only detected before pneumoperitoneum, but also in 5, 10, 15 and 20 minutes after pneumoperitoneum. Results: PES after pneumoperitoneum in VC mode was obviously higher than that in PC and PRVC groups. In 10 minutes after pneumoperitoneum, levels of PaCO2 and ETCO2 became increased obviously in PC and VC groups (p < .05); levels of PaCO2 and ETCO2 were not only increased in PC group, but also the level of TV after pneumoperitoneum in PC group was significantly lower than that in the other two groups (p < .05). Levels of PaCO2 and ETCO2 were increased in PC and VC groups after pneumoperitoneum, along with the increase of MAP and HR (p < .05). After pneumoperitoneum, levels of MAP and HR in PRVC group were significantly lower than those in PC and VC groups (p < .05). Conclusions: PRVC mode can effectively reduce the pneumoperitoneum-induced increase of PAWM, PAP and PES without the unusual increase of PaCO2 and ETCO2 during surgery, so as to guarantee the stability of vital signs in perioperative patients.

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Proteasome and C-reactive protein inflammatory response in children undergoing shorter and longer lasting laparoscopic cholecystectomy

Tylicka

Matuszczak

Karpińska

et al. 2017

Scandinavian Journal of Clinical and Laboratory Investigation

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Operations of varying duration cause the release of a number of inflammatory mediators, in particular cytokines which lead to proteasome and acute-phase reactions. The purpose of this novel human study, was to characterize inflammatory response in children undergoing laparoscopic cholecystectomy, by analyzing changes in selected inflammatory mediators: C-reactive protein concentration and circulating 20S proteasome activity following surgical injury and to correlate them with the duration of the surgical procedure. Plasma C-reactive protein concentration (CRP) was determined by standard biochemical laboratory procedures. Proteasome activity in the plasma of children was assessed using Suc-Leu-Leu-Val-Tyr-AMC peptide substrate. Statistically significant increase in the plasma proteasome activity and C-reactive protein concentration, was noted (p < .05) in children after laparoscopic cholecystectomy. We found the correlation between the 20S proteasome activity and the length of the procedure. In children undergoing longer lasting laparoscopic cholecystectomy the proteasome activity was much higher than in patients having shorter surgical procedure. The CRP concentration and 20S proteasome activity significantly increase after surgery, but only 20S proteasome activity correlate with the length of the surgery. This may confirm that CRP is only an indicator of pathological state, while the function of the proteasomes is more complex because of their participation in the processes of repair and wound healing, and in the removal of damaged proteins.

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Evaluation of systemic inflammatory responses in cholecystectomy by means of access. Single-port umbilical incision, transvaginal NOTES, laparoscopy and laparotomy

Abstract: Conception and design of the study; acquisition, analysis and interpretation of data; drafting the article; final approval of the version to be published.

Cited by 4 publications

References 35 publications

A prospective randomized study of the inflammatory responses to multiport and singleport laparoscopic hysterectomies

A prospective randomized study of the inflammatory responses to multiport and singleport laparoscopic hysterectomies

Application of PRVC in laparoscopic surgery

Proteasome and C-reactive protein inflammatory response in children undergoing shorter and longer lasting laparoscopic cholecystectomy

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