African Journal of Medicine and Surgery

African Journal of Medicine and Surgery Vol. 1 (3), pp. 020-023, October, 2013. © International Scholars Journals
 
Review 

Inflammatory response after laparoscopic versus open colonic resection: Review of the literature

Dimitrios Tsamis1, George Theodoropoulos1, V. Nikolaos Michalopoulos1, Thalassini Delistathi1, Nikolaos Nikiteas2, Christos Tsigris3 and Emmanuel Leandros1

1Propedeutic Surgical Department, Hippokration University Hospital, Athens Medical School, Athens, Greece.

2Propedeutic Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece.

3Surgical Department, Laiko University Hospital, Athens Medical School, Athens, Greece.

*Corresponding author. E-mail: tsamisdim@hotmail.com. Tel: 0030 6937334858. Fax: 0030 2107792819.

Accepted 31 March, 2013

Abstract

Surgical trauma may lead to immune dysfunction as a result of the intense inflammatory response which arises in order to restore tissue function. The inflammatory response after surgical trauma is mediated by a number of substances which are produced at the site of wounded and manipulated tissues or at more distant places and they can act locally and systematically. These substances are TNF, Interleukins, Heat shock proteins, etc. Laparoscopic surgery is associated with reduced surgical trauma, much less manipulation of tissues and an environment of CO2 pneumoperitoneum comparatively with open procedures. All of these contribute to the theory that laparoscopic colonic resections are expected to be associated with less inflammatory and acute phase response than open resections. As indices of inflammation in colon surgery cytokines, such as TNF, Interleukins and CRP are the most studied ones. From the studies which are reviewed, comparing these cytokines in serum and peritoneal fluids in patients undergoing open versus laparoscopic colectomy, some showed that inflammatory response after laparoscopic colorectal resections seems to be slightly attenuated, as long as values of IL-6, IL-8 and CRP in peripheral blood are in lower levels in the first postoperative hours than open procedures. This phenomenon was not noticed in all studies and for other inflammatory and anti-inflammatory cytokines in the serum of the patients or in the peritoneal fluids.

Key words: Laparoscopic colectomy, open colectomy, inflammatory response.