Metabolic and Functional Results After Laparoscopic Colorectal SurgeryA Randomized, Controlled Trial
作者:
Marco Braga,
Andrea Vignali,
Walter Zuliani,
Giovanni Radaelli,
Luca Gianotti,
Carla Martani,
Gilles Toussoun,
Valerio Di Carlo,
期刊:
Diseases of the Colon & Rectum
(OVID Available online 2002)
卷期:
Volume 45,
issue 8
页码: 1070-1077
ISSN:0012-3706
年代: 2002
出版商: OVID
关键词: Laparoscopy;Colorectal surgery;Metabolic response;Immune response
数据来源: OVID
摘要:
PURPOSE:This study was designed to compare metabolic and functional results after laparoscopic and open colorectal resection.METHODS:Seventy‐nine patients were randomly assigned to laparoscopic (n = 40) or open (n = 39) colorectal resection. Before and after operation, the following parameters were determined: respiratory function (spirography and blood gas); serum level of cortisol, lactate, and C‐reactive protein; total lymphocyte count; and CD4 and CD8 lymphocyte subsets. Intraoperative core temperature was measured by a bladder probe. Postoperative pain and analgesic consumption were also monitored.RESULTS:Mild operative hypothermia, a trend to postoperative reduction of total lymphocyte count, and significant impairment of respiratory function early after surgery were found in both groups. Laparoscopy showed a higher CD4/CD8 ratio (P= 0.01) on postoperative Day 1 and a faster return of C‐reactive protein to preoperative values (P= 0.01) than in the open colorectal resection group. Morphine consumption in the first 48 hours after surgery was lower in the laparoscopic than in the open group (P= 0.02).CONCLUSIONS:Laparoscopy was associated with a less pronounced immunosuppression and inflammatory response and a lower consumption of analgesic drugs than open surgery. Moreover, our data did not show any additional detrimental effect of laparoscopy on either operative core temperature or early postoperative respiratory function.
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