Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Schietroma, M; Piccione, Federica; Carlei, F; Clementi, Marco; Bianchi, Zuleyka; Vita, Fabiola De; Amicucci, Gianfranco

doi:10.1177/000313481207800541

Cited by 42 publications

(24 citation statements)

References 32 publications

(27 reference statements)

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“…A reduced inflammatory response has been considered an advantage of laparoscopy compared with open surgery. A reduced inflammatory response has been found following minimally invasive colorectal surgery, 8 cholecystectomy, 9 appendectomy, 10 perforated ulcer repair, 11 and lung resection, 12 when compared with open procedures. Decreased interleukin 6 (IL-6) after laparoscopic surgery was the most consistent finding in these studies.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases

et al. 2015

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Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at −80 oC. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.

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Section: Introductionmentioning

confidence: 99%

Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases

et al. 2015

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“…Four of which were randomized controlled trials (RCT). Three of the RCTs were from a single hospital comparing open surgery versus laparoscopy for treating perforated appendicitis, perforated peptic ulcer, or cholecystitis with sepsis [ 120 – 122 ]. Bakker et al .…”

Section: Resultsmentioning

confidence: 99%

Inflammatory mediators in intra-abdominal sepsis or injury – a scoping review

et al. 2015

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IntroductionInflammatory and protein mediators (cytokine, chemokine, acute phase proteins) play an important, but still not completely understood, role in the morbidity and mortality of intra-abdominal sepsis/injury. We therefore systematically reviewed preclinical and clinical studies of mediators in intra-abdominal sepsis/injury in order to evaluate their ability to: (1) function as diagnostic/prognostic biomarkers; (2) serve as therapeutic targets; and (3) illuminate the pathogenesis mechanisms of sepsis or injury-related organ dysfunction.MethodsWe searched MEDLINE, PubMed, EMBASE and the Cochrane Library. Two investigators independently reviewed all identified abstracts and selected articles for full-text review. We included original studies assessing mediators in intra-abdominal sepsis/injury.ResultsAmong 2437 citations, we selected 182 studies in the scoping review, including 79 preclinical and 103 clinical studies. Serum procalcitonin and C-reactive protein appear to be useful to rule out infection or monitor therapy; however, the diagnostic and prognostic value of mediators for complications/outcomes of sepsis or injury remains to be established. Peritoneal mediator levels are substantially higher than systemic levels after intra-abdominal infection/trauma. Common limitations of current studies included small sample sizes and lack of uniformity in study design and outcome measures. To date, targeted therapies against mediators remain experimental.ConclusionsWhereas preclinical data suggests mediators play a critical role in intra-abdominal sepsis or injury, there is no consensus on the clinical use of mediators in diagnosing or managing intra-abdominal sepsis or injury. Measurement of peritoneal mediators should be further investigated as a more sensitive determinant of intra-abdominal inflammatory response. High-quality clinical trials are needed to better understand the role of inflammatory mediators.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-015-1093-4) contains supplementary material, which is available to authorized users.

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“…In patients with PPU, mortality is associated with sepsis and inflammation. Because inflammation has been alleviated after elective laparoscopic surgery 47 48 , this minimally invasive approach for PPU, which is an emergency condition, is correlated more closely with patient risk factors than surgical complications 49 . Thus, the selection bias of patients may lead to a higher mortality rate after OR.…”

Section: Discussionmentioning

confidence: 99%

An Updated Meta-Analysis of Laparoscopic Versus Open Repair for Perforated Peptic Ulcer

Zhou

Wang

et al. 2015

Sci Rep

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Laparoscopic repair (LR) for perforated peptic ulcer (PPU) has been introduced since 1990. Although many studies comparing LR with open repair (OR) have been published, controversy remains regarding the clinical utility of laparoscopic techniques for the treatment of PPU. Thus, it is necessary for us to broaden our knowledge on this subject with the newly published articles. Twenty-four nonrandomized controlled studies (NRS) and five randomized controlled trails (RCTs) were included in our meta-analyses, which comprised 5,268 patients (1,890 in the LR group and 3,378 in the OR group). In the analysis of high quality NRS and RCTs, compared with OR, high quality evidence suggested that LR was associated with a lower incidence of overall postoperative complications; moderate evidence showed that the two procedures had the similar reoperation rate; based on the low quality evidence, LR had reduced hospital mortality and similar operative time; Moreover, LR was observed having the advantages of earlier resumption of oral intake, shorter hospital stay and less analgesic use, which were supported by very low evidence. All the evidences suggest that LR is better than OR for PPU, but more high-quality RCTs are still needed for further validation.

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Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

Cited by 42 publications

References 32 publications

Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases

Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases

Inflammatory mediators in intra-abdominal sepsis or injury – a scoping review

An Updated Meta-Analysis of Laparoscopic Versus Open Repair for Perforated Peptic Ulcer

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