Metabolic and functional results after laparoscopic colorectal surgery: A randomized, controlled trial

Marco Braga, Andrea Vignali, Walter Zuliani, Giovanni Radaelli, Luca Gianotti, Carla Martani, Gilles Toussoun, Valerio Di Carlo

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1070-1077
Number of pages8
JournalDiseases of the Colon and Rectum
Volume45
Issue number8
DOIs
Publication statusPublished - Aug 2002

Keywords

  • Colorectal surgery
  • Immune response
  • Laparoscopy
  • Metabolic response

ASJC Scopus subject areas

  • Gastroenterology

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    Braga, M., Vignali, A., Zuliani, W., Radaelli, G., Gianotti, L., Martani, C., Toussoun, G., & Di Carlo, V. (2002). Metabolic and functional results after laparoscopic colorectal surgery: A randomized, controlled trial. Diseases of the Colon and Rectum, 45(8), 1070-1077. https://doi.org/10.1007/s10350-004-6362-2