Immune Response to Laparoscopic Bowel Injury

Aldana, Joel Patrick A.; Marcovich, Robert; Singhal, Pravin C.; Reddy, Krishna; Morgenstern, Nora; El-Hakim, Assaad; Smith, Arthur D.; Lee, Benjamin R.

doi:10.1089/089277903322145503

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…[18,19] In our study, neutrophil levels were significantly elevated at 2nd hour, when the focal mucosal necrosis accompanied by dilated mucosal and submucosal vessels seen histopathologically. In some studies, it is predicted that there is a doubling of neutrophil count approximately three hours after surgery.…”

Section: Figsupporting

confidence: 49%

Correlation Of Biochemical Markers With Histopathological Findings In Experimental Strangulated Hernia

Peker¹,

Yıldız²,

Zeybek³

et al. 2009

TUTFD

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Objectives: This study was planned to evaluate whether possible changes in the hematological parameters and the biochemical markers can be used to detect obstruction-induced (strangulated) intestinal ischemia. Materials and Methods:Forty rats divided into five groups underwent the following procedures: Group 1 rats were treated with only laparotomy (sham-operated controls). To the strangulated hernia groups surgical induction of strangulated intestinal obstruction was performed. Tissue and blood samples were taken at 30 minutes (group 2), 2nd hour (group 3), 4th hour (group 4) and 6th hour (group 5) respectively, and then LDH, CPK, ALP, AST, ALT, D-dimer levels and blood cells counts were measured and histopathological examination was done.Results: Focal mucosal necrosis accompanied was confirmed by histological findings in the strangulated intestinal ischemia group after second hour. Serum D-dimer, ALT, ALP, CPK levels and neutrophil count became elevated at second hour, which was statistically significant. Conclusion:In patients with hernia, after reduction of the intestinal hernia, raised levels of serum D-dimer, ALT, ALP, CPK levels and neutrophil count may indicate the presence of a bowel ischemia. However, more comprehensive clinical studies are required to evaluate the potential survival benefit by using the laboratory tests as a marker and/or a useful diagnostic tool of the need for laparotomy.

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Section: Figsupporting

confidence: 49%

Correlation Of Biochemical Markers With Histopathological Findings In Experimental Strangulated Hernia

Peker¹,

Yıldız²,

Zeybek³

et al. 2009

TUTFD

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“…23 Animal experiments suggest that these unusual findings are the result of reduced activation of the immune system and the acute response to injury that occurs during laparoscopic relative to open surgery. 37 These presenting signs can be followed rapidly by decompensation and death, highlighting the need for early recognition and intervention. A CT scan of the abdomen and pelvis can be helpful in identifying the source of a postoperative problem and has been shown to provide a symptom-related diagnosis in 75% of patients with a suspected complication following laparoscopy.…”

Section: Bowel Injurymentioning

confidence: 99%

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Hedican

2004

Journal of Endourology

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Since the first urologic case was reported in 1997, hand-assisted laparoscopic surgery (HALS) has proven to be useful for both the experienced and the inexperienced laparoscopic surgeon. In a recent series of 196 cases at three major medical institutions, 18 patients (9.2%) suffered 32 major complications, and 28 patients (14.3%) had 31 minor complications. The most common major complications were small-bowel injury, requirement for open conversion to control bleeding, and need for reintubation. The most frequent minor complications were urinary retention, splenic capsular injury, and prolonged ileus. The author discusses ways of recognizing and managing the complications of HALS, including physiologic, access-related, intraoperative, and post-operative problems.

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“…Elevated serum cortisol levels are indicative of surgical stress [19,20]. In the present study, both the laparoscopic and open surgical approaches caused an increased serum cortisol level.…”

Section: Discussionmentioning

confidence: 50%

Comparison of the neuroendocrine and inflammatory responses after laparoscopic and abdominal hysterectomy

Kim

Yoon

2010

Korean J Anesthesiol

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BackgroundLaparoscopic surgery is associated with a more favorable clinical outcome than that of conventional open surgery. This might be related to the magnitude of the tissue trauma. The aim of the present study was to examine the differences of the neuroendocrine and inflammatory responses between the two surgical techniques.MethodsTwenty-four patients with no major medical disease were randomly assigned to undergo laparoscopic (n = 13) or abdominal hysterectomy (n = 11). Venous blood samples were collected and we measured the levels of interleukin-6 (IL-6), CRP and cortisol at the time before and after skin incision, at the end of peritoneum closure and at 1 h and 24 h after operation.ResultsThe laparoscopic hysterectomy group demonstrated less of an inflammatory response in terms of the serum IL-6 and CRP responses than did the abdominal hysterectomy group, and the laparoscopic hysterectomy group had a shorter hospital stay (P < 0.05). The peak serum IL-6 (P < 0.05) and CRP concentrations were significantly less increased in the laparoscopic group as compared with that of the abdominal hysterectomy group (P < 0.05), while the serum cortisol concentration showed a similar time course and changes and there were no significant difference between the groups. The response of interleukin-6 showed a significant correlation with the response of CRP (r = 0.796; P < 0.05).ConclusionsThe laparoscopic surgical procedure leaves the endocrine metabolic response largely unaltered as compared with that of open abdominal hysterectomy, but it reduces the inflammatory response as measured by the IL-6 and CRP levels.

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Immune Response to Laparoscopic Bowel Injury

Cited by 11 publications

References 14 publications

Correlation Of Biochemical Markers With Histopathological Findings In Experimental Strangulated Hernia

Correlation Of Biochemical Markers With Histopathological Findings In Experimental Strangulated Hernia

Complications of Hand-Assisted Laparoscopic Urologic Surgery

Comparison of the neuroendocrine and inflammatory responses after laparoscopic and abdominal hysterectomy

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