Background: Although the immunologic benefits of laparoscopic surgery have been established, effects from hand-assisted (HA) surgery have not been investigated thoroughly. We hypothesized that the HA approach maintains the immunologic advantage of laparoscopic surgery compared with the open (O) approach.
Methods: Six O, HA, and laparoscopic (L) transabdominal left nephrectomies were performed on pigs. Blood samples were taken preoperatively, perioperatively, and postoperatively, and serum interleukin-6 and C-reactive protein levels were measured.
Results: At 24 hours after surgery, interleukin-6 levels were significantly higher in the O group vs the HA and L groups (82.2 vs 37.5 and 29.9 pg/mL, respectively; P < .05). Similar trends were seen at all time periods for both IL-6 and C-reactive protein. No significant differences in postoperative cytokine levels were detected between the HA and L groups.
Conclusions: The HA approach mimics the immunologic effects of laparoscopic surgery. These data suggest that the HA technique resulted in a reduced systemic immune activation in the early perioperative period when compared with open surgery. In addition to clinical benefits of minimal access, the HA approach also may afford patients an immunologic advantage over laparotomy.
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http://dx.doi.org/10.1016/j.amjsurg.2010.09.026 | DOI Listing |
Trials
January 2025
Department of Anaesthesiology, The Third People's Hospital of Chengdu, Chengdu, China.
Background: Lung ultrasound-guided alveolar recruitment manoeuvres (RMs) may reduce the lung ultrasound score. However, whether the use of this strategy can reduce the incidence of postoperative pulmonary complications (PPCs) in the adult obese population has not yet been tested.
Methods/design: This is a single-centre, two-arm, prospective, randomised controlled trial.
Perioper Med (Lond)
January 2025
Department of Surgery, Yale School of Medicine, New Haven, CT, 06510, USA.
Background: Irrespective of baseline diabetes status, preoperative hemoglobin A1c (A1C) influences perioperative care in patients undergoing metabolic and bariatric surgery (MBS). Accordingly, the American Society of Metabolic and Bariatric Surgery (ASMBS) endorses that patients undergoing MBS should receive a preoperative A1C test. We aimed to assess the proportion of MBS patients who received a preoperative A1C test and determine whether baseline diabetes status influences receipt of a test.
View Article and Find Full Text PDFBMC Anesthesiol
January 2025
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Background: High-frequency, high-intensity transcutaneous electrical nerve stimulation (HFHI TENS, i.e. 80 Hz and 40-60 mA) is an effective, fast-acting pain relief modality after elective surgery, offering pain relief within 5 min.
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN, USA.
Background: The incidence of rectal cancer has decreased overall, but the incidence of early-onset rectal cancer (eoRC) has increased. Early-onset rectal cancer and late-onset rectal cancer (loRC) differ due to phenotypical, genetic characteristics, and higher stage presentations in eoRC. Thus, eoRC patients undergo more aggressive neoadjuvant treatments.
View Article and Find Full Text PDFAnn Surg Oncol
January 2025
Division of Colorectal Surgery, Changzheng Hospital, Navy Medical University, Shanghai, China.
Background: Local relapse has not been eradicated even in the era of total mesorectum excision. Although various approaches have been attempted, R0 resection remains the only potentially curative treatment. PATIENT AND METHODS: A 45-year-old woman with a history of laparoscopic abdominoperineal resection was diagnosed with pelvic recurrence 7 months ago.
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