BACKGROUND: In previous comparisons of inflammatory and stress responses to open (OR) and laparoscopic (LR) hernia repair, all operations were performed under general anesthesia. Since local anesthesia is widely used for OR, a comparison of this approach with LR seemed relevant. METHODS:Patients with recurrent inguinal hernia were randomized to OR under local anesthesia (n = 30) or LR under general anesthesia (n = 31). The magnitude of the surgical trauma was assessed by measuring markers of coagulation (prothrombin fragment 1 + 2), endothelial activation (von Willebrand factor), inflammation [leukocytes, interleukin-6, -8 and -10, granulocyte macrophage colony-stimulating factor, and C-reactive protein (CRP)], and endocrine stress (cortisol) in blood collected before operation, 4 h postincision, and on postoperative day 2. RESULTS:Leukocyte counts and interleukin-6 and CRP levels increased in both groups, with the CRP increase being significantly greater in the OR group. The other markers did not increase significantly. CONCLUSION: The acute phase response was more pronounced after OR, even when this was done under local anesthesia. Both techniques seemed rather atraumatic.
RCT Entities:
BACKGROUND: In previous comparisons of inflammatory and stress responses to open (OR) and laparoscopic (LR) hernia repair, all operations were performed under general anesthesia. Since local anesthesia is widely used for OR, a comparison of this approach with LR seemed relevant. METHODS:Patients with recurrent inguinal hernia were randomized to OR under local anesthesia (n = 30) or LR under general anesthesia (n = 31). The magnitude of the surgical trauma was assessed by measuring markers of coagulation (prothrombin fragment 1 + 2), endothelial activation (von Willebrand factor), inflammation [leukocytes, interleukin-6, -8 and -10, granulocyte macrophage colony-stimulating factor, and C-reactive protein (CRP)], and endocrine stress (cortisol) in blood collected before operation, 4 h postincision, and on postoperative day 2. RESULTS: Leukocyte counts and interleukin-6 and CRP levels increased in both groups, with the CRP increase being significantly greater in the OR group. The other markers did not increase significantly. CONCLUSION: The acute phase response was more pronounced after OR, even when this was done under local anesthesia. Both techniques seemed rather atraumatic.
Authors: K Ido; T Suzuki; K Kimura; Y Taniguchi; C Kawamoto; N Isoda; N Nagamine; T Ioka; M Kumagai; Y Hirayama Journal: Surg Endosc Date: 1995-03 Impact factor: 4.584
Authors: B Chernow; H R Alexander; R C Smallridge; W R Thompson; D Cook; D Beardsley; M P Fink; C R Lake; J R Fletcher Journal: Arch Intern Med Date: 1987-07
Authors: Jan Ulrych; Tomas Kvasnicka; Vladimir Fryba; Martin Komarc; Ivana Malikova; Filip Burget; Radka Brzezkova; Jan Kvasnicka; Zdenek Krska; Jan Kvasnicka Journal: BMC Surg Date: 2016-04-06 Impact factor: 2.102
Authors: F Köckerling; R Bittner; A Kuthe; B Stechemesser; R Lorenz; A Koch; W Reinpold; H Niebuhr; M Hukauf; C Schug-Pass Journal: Surg Endosc Date: 2016-12-08 Impact factor: 4.584