Humoral Mediator Fluctuations after Laparoscopic and Open Gastrectomy

Tetsu Fukunaga, Akio Kidokoro, Masaki Fukunaga and kunihiko Nagakari

Department of Surgery, Juntendo University Urayasu Hospital, Juntendo University, School of Medicine

Transient humoral mediator levels are reflected in the stress response to surgical trauma. The aim of this study was to assess the humoral mediator levels in patients undergoing laparoscopic distal gastrectomy with D1+α lymph node resection (LDG) and Open distal gastrectomy with D1+α lymph node resection (ODG). The patients in both groups (LDG, n=10 ODG, n=10) were comparable in age, sex, and cancer stage. Serum levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and polymorphonuclear leukocyte elastase (PMN-E) were determined preoperatively and postoperatively at 0, 1, and 3 days. IL-6 and IL-10 increased shortly after both operations. There was no statistical difference between the two groups with respect to changes in IL-6 and IL-10 levels (IL-6, p=0. 1 IL-10, p=0. 78). The PMN-E level in the LDG group did not increase and remained low during the perioperative period in comparison with the ODG group, and indicated a significant difference between the two groups (p=0. 04) . LDG results showed a diminished stress response during the postoperative period, suggesting a less invasive surgery in comparison with ODG.

Key words
surgical stress, laparoscopic distal gastrectomy, interleukin-6, interleukin-10, polymorphonuclear leukocyte elastase

Reprint requests
Tetsu Fukunaga Department of Surgery, Juntendo University Urayasu Hospital, Juntendo University, School of Medicine 2-1-1 Tomioka, Urayasu-chi, 279-0021 JAPAN

Accepted
April 26, 2000

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