General Stress Response to Conventional and Laparoscopic Cholecystectomy

Glaser, F.; Sannwald, G.; Buhr, H. J.; Kuntz, C.; Mayer, Hermann; Klee, F; Herfarth, Ch.

doi:10.1097/00000658-199504000-00007

Cited by 208 publications

(147 citation statements)

References 25 publications

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“…[1][2][3][4][5] Several additional hormones were proposed for measuring the body's immune and metabolic response to surgery, such as IL-1beta, IL-6, IL-8 and others. [6][7][8][9] The main and most reliable peripheral hormones that correlated well with the extent of the surgical trauma were cortisol and the catecholamines. In this light, this study investigated the suitability of these hormones for reflecting the body's response to the wounds of open and laparoscopic cholecystectomy and adrenalectomy in an animal model.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] The surgical wound, depending on its size, disturbs homeostasis and activates the stress system. [1][2][3][4][5][6][7] In recent years, laparoscopic surgery has been applied both for the diagnosis and treatment of an ever expanding range of diseases, hitherto treated only by open laparotomy. The laparoscopic method has been widely accepted in the treatment of symptomatic gallstones and for removing the adrenal glands.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Krikri¹,

Alexopoulos²,

Zoumakis³

et al. 2013

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ObJEcTIVE: Minimally invasive operations, such as laparoscopic cholecystectomy and adrenalectomy, result in a more rapid recovery of normal function, less physiological disturbances and less stress to the organism than similar open operations. The purpose of this study was to determine the stress response associated with minimally invasive abdominal surgery compared to conventional small or large incision laparotomy. METHODs: We compared the responses of the stress hormones cortisol and the catecholamines adrenaline and noradrenaline to elective conventional and laparoscopic cholecystectomy and unilateral adrenalectomy in male pigs. blood samples were taken from all animals at the same time, one day before surgery, at the beginning of the operation, every 15 minutes during surgery and on the first postoperative morning. rEsULTs: Plasma adrenaline and noradrenaline concentrations were significantly lower in both cholecystectomies (p<0.05) and adrenalectomies (p<0.01) during laparoscopic than during open surgery. Plasma cortisol levels were significantly lower in laparoscopic than in open adrenalectomies both during surgery and on postoperative day one (p<0.05), while no major differences in cortisol levels were observed between laparoscopic and open cholecystectomies. Thus, the stress-related benefit of laparoscopic surgery depended on the size of the surgical incision in the conventional operation. cONcLUsION: Laparoscopic surgery was associated with less surgical stress than open surgery and this difference was accentuated as the surgical abdominal wall trauma increased.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Krikri¹,

Alexopoulos²,

Zoumakis³

et al. 2013

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“…Hanly et al 19 proposed that CO 2 -mediated attenuation of the acute phase response may be the underlying mechanism of reduced systemic inflammatory response reported in earlier laparoscopic surgeries. [20][21][22] The immune-modulatory effect of CO 2 is apparently mediated by peritoneal acidosis as acidic solutions had the same effect. 23 Therefore, we speculate that abdominal CO 2 insufflation, rather than reduced tissue trauma, may account for underexpression of stress-response genes in LRP specimens compared with ORP specimens.…”

Section: Discussionmentioning

confidence: 99%

Effect of surgical procedures on prostate tumor gene expression profiles

Li¹,

Zhang²,

Yin³

et al. 2012

Asian J Androl

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Current surgical treatment of prostate cancer is typically accomplished by either open radical prostatectomy (ORP) or robotic-assisted laparoscopic radical prostatectomy (RALRP). Intra-operative procedural differences between the two surgical approaches may alter the molecular composition of resected surgical specimens, which are indispensable for molecular analysis and biomarker evaluation. The objective of this study is to investigate the effect of different surgical procedures on RNA quality and genome-wide expression signature. RNA integrity number (RIN) values were compared between total RNA samples extracted from consecutive LRP (n511) and ORP (n524) prostate specimens. Expression profiling was performed using the Agilent human whole-genome expression microarrays. Expression differences by surgical type were analyzed by Volcano plot analysis and gene ontology analysis. Quantitative reverse transcription (RT)-PCR was used for expression validation in an independent set of LRP (n58) and ORP (n58) samples. The LRP procedure did not compromise RNA integrity. Differential gene expression by surgery types was limited to a small subset of genes, the number of which was smaller than that expected by chance. Unexpectedly, this small subset of differentially expressed genes was enriched for those encoding transcription factors, oxygen transporters and other previously reported surgery-induced stress-response genes, and demonstrated unidirectional reduction in LRP specimens in comparison to ORP specimens. The effect of the LRP procedure on RNA quality and genome-wide transcript levels is negligible, supporting the suitability of LRP surgical specimens for routine molecular analysis. Blunted in vivo stress response in LRP specimens, likely mediated by CO 2 insufflation but not by longer ischemia time, is manifested in the reduced expression of stress-response genes in these specimens. Asian Journal of Andrology (2012) 14, 708-714; doi:10.1038/aja.2012.54; published online 6 August 2012Keywords: CO 2 insufflation; expression microarray; laparoscopic radical prostatectomy; open radical prostatectomy; prostate cancer; stress response INTRODUCTION Currently, for men with localized prostate cancer, surgical resection of the prostatic tumor is most often accomplished by one of two surgical approaches, open radical prostatectomy (ORP) or robot-assisted laparoscopic radical prostatectomy (RALRP), with the latter operation being increasingly practiced in developed countries. In the United States, RALRP accounts for an estimated 80% of RP surgeries. 1 In China, while RALRP is rarely performed, a substantial percentage of RP surgeries are nevertheless performed minimally invasively, via traditional laparoscopic radical prostatectomy (LRP). LRP is quite similar to RALRP and involves similar surgical approaches and steps that are different from conventional ORP. 2 The principal distinctions in sequential surgical steps between LRP and ORP are illustrated in Figure 1. During LRP, the prostate is typically devascularized earlier by ...

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“…Compared to an open approach, minimally invasive techniques have proven effective in reducing surgical trauma, thereby improving patient recovery and length of hospital stay [1,2]. Benefits of improved postoperative pain and cosmesis are now well established for many operations [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases

et al. 2011

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Laparoscopic cholecystectomy is the gold standard for gallbladder removal and the most common laparoscopic procedure worldwide. With the advent of laparoscopic surgery and its continuous development, the focus has shifted to 'scarless' surgery. In recent times, the innovative technique of single-incision laparoscopic surgery (SILS) has been applied in gallbladder removal and even more complex biliopancreatic procedures to further minimize the invasiveness of the surgery. Newer developments in laparoscopic equipments and instrumentation have helped to further evolve this field of minimally invasive surgery. Literature search was performed using the following online search engines: Google, Medline, PubMed, Cochrane, and the online Springer link library. The terms used for the search were as follows: SILS, LESS, singleincision laparoscopic surgery, single-port laparoscopic surgery, SILS cholecystectomy, and SILS pancreatic surgery. Articles that matched the search criteria were selected and extensively reviewed. Moreover, pertinent information on instrumentation and technology for SILS and LESS was obtained by accessing websites of manufacturers. Although SILS represents the search for an essentially scarless surgery, there is still not a widespread use and uniformity of this procedure. SILS is performed either by single-or multiple-port technique. In the present article, we present a review of the potential benefits, limitations, and risks of SILS in biliary and pancreatic diseases. There are many studies showing benefits in cholecystectomy. A few case reports have also emerged about its feasibility in procedures such as cystogastrostomy and limited pancreatic resection. Further research and development of this technique is needed to arrive at a tangible conclusion about the perceived benefits of SILS. Randomized studies to compare SILS with traditional laparoscopy are essential.

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General Stress Response to Conventional and Laparoscopic Cholecystectomy

Cited by 208 publications

References 25 publications

Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Laparoscopic vs. open abdominal surgery in male pigs: Marked differences in cortisol and catecholamine response depending on the size of surgical incision

Effect of surgical procedures on prostate tumor gene expression profiles

Single-Incision Laparoscopic Surgery (SILS) in Biliary and Pancreatic Diseases

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