Effect of prednisolone on local and systemic response in laparoscopic vs. open colon surgery: A randomized, double-blind, placebo-controlled trial

Andrea Vignali, Saverio Di Palo, Elena Orsenigo, Luca Ghirardelli, Giovanni Radaelli, Carlo Staudacher

Research output: Contribution to journalArticle

Abstract

PURPOSE: This study was designed to assess whether preoperative, short-term, intravenously administered high doses of methylprednisolone (30 mg/kg 90 minutes before surgery) influence local and systemic biohumoral responses in patients undergoing laparoscopic or open resection of colon cancer. METHODS: Fifty-two patients who were candidates for curative colon resection were randomly assigned to laparoscopic or open surgery and, in a double-blind design, assigned to receive methylprednisolone (n = 26) or placebo (n = 26). Pulmonary function, postoperative pain, C-reactive protein, interleukins 6 and 8, and tumor necrosis factor α were analyzed, as was patient outcome. RESULTS: The steroid and placebo groups were well balanced for preoperative variables, as were the subgroups of patients who underwent laparoscopic (methylprednisolone, n = 13; placebo, n = 13) and open surgery (methylprednisolone, n = 13; placebo, n = 13). No adverse events related to steroid administration occurred. In the methylprednisolone groups, significant improvement in pulmonary performance (P = 0.01), pain control (P = 0.001), and length of stay (P = 0.03) were observed independent of the surgical technique. No differences in morbidity or anastomotic leak rate were observed among groups. CONCLUSION: Preoperative administration of methylprednisolone in colon cancer patients may improve pulmonary performance and postoperative pain, and shorten length of stay regardless of the surgical technique used (laparoscopy, open colon resection).

Original languageEnglish
Pages (from-to)1080-1088
Number of pages9
JournalDiseases of the Colon and Rectum
Volume52
Issue number6
DOIs
Publication statusPublished - Jun 2009

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Keywords

  • Colon cancer
  • Laparoscopy
  • Methylprednisolone
  • Postoperative pain
  • Proinflammatory cytokines
  • Pulmonary function

ASJC Scopus subject areas

  • Gastroenterology

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