BACKGROUND: Endourology, extracorporeal shock wave lithotripsy (ESWL), and laparoscopic surgery are considered minimally invasive procedures; however, estimation of operative invasiveness has not been fully accomplished. We measured serum interleukin-6 (IL-6) levels, as an indicator for systemic reaction, to examine operative invasiveness of these operations in comparison with open surgery. METHOD: Serum IL-6 levels were measured in 119 patients undergoing open surgery, laparoscopic surgery, endourology, and ESWL. RESULTS: The median IL-6 levels on day 1 after the operation varied according to operative procedures: 83.5 pg/mL (range, 15-340 pg/mL) for open surgery, 24.8 pg/mL (range, 12-42 pg/mL) for laparoscopic surgery, and 10.8 pg/mL (range, 0-85 pg/mL) for endourology and ESWL. The extent of tissue injury and blood loss were found to be 2 major factors responsible for the serum IL-6 elevation. CONCLUSION: The minimally invasive character of endourology, ESWL, and laparoscopic surgery is attributable to low levels of tissue injury and blood loss, regardless of operative time.
BACKGROUND: Endourology, extracorporeal shock wave lithotripsy (ESWL), and laparoscopic surgery are considered minimally invasive procedures; however, estimation of operative invasiveness has not been fully accomplished. We measured serum interleukin-6 (IL-6) levels, as an indicator for systemic reaction, to examine operative invasiveness of these operations in comparison with open surgery. METHOD: Serum IL-6 levels were measured in 119 patients undergoing open surgery, laparoscopic surgery, endourology, and ESWL. RESULTS: The median IL-6 levels on day 1 after the operation varied according to operative procedures: 83.5 pg/mL (range, 15-340 pg/mL) for open surgery, 24.8 pg/mL (range, 12-42 pg/mL) for laparoscopic surgery, and 10.8 pg/mL (range, 0-85 pg/mL) for endourology and ESWL. The extent of tissue injury and blood loss were found to be 2 major factors responsible for the serum IL-6 elevation. CONCLUSION: The minimally invasive character of endourology, ESWL, and laparoscopic surgery is attributable to low levels of tissue injury and blood loss, regardless of operative time.