Comparison of endocrinological and cytokine response to trauma in laparoscopic and conventional appendectomy in patients with acute appendicitis

Abstract

PURPOSE: In this study, we compared the endocrine and cytokine reaction of the patients which laparoscopic and conventional appendectomy was done for acute appendicitis.

MATERIALS AND METHOD: 50 patients who were operated for acute appendicitis in Ankara Atatürk Research and Training Hospital between the dates December 2013 and February 2014 were enrolled and grouped as either laparoscopic or conventional. Serum ACTH, IL-6 and CRP levels were obtained at induction of anesthesia and postoperative 6th hour.

RESULTS: There was no significant difference between the groups in terms of gender, co-morbidities, and perforation rate. Preoperative ACTH levels were similar for both groups while it is significantly lower in postoperative period for laparoscopy group. Moreover, IL-6 levels were also higher in postoperative period for conventional period compared to laparoscopy group. Despite preoperative CRP value of the laparoscopic group was significantly higher than the conventional group, postop values showed no statistical difference. The mean operation time of the laparoscopic appendectomy group was significantly higher than the conventional group.

CONCLUSION: Laparoscopic appendectomy causes less metabolic and cytokine response than conventional surgery. ACTH and IL-6 levels could be assessed to evaluate metabolic outcome of surgical intervention.