METABOLIC AND INFLAMMATORY RESPONSES AFTER LAPAROSCOPIC AND OPEN INGUINAL-HERNIA REPAIR

A prospective comparison of metabolic and inflammatory responses after laparoscopic and open inguinal hernia operations was undertaken. Ther e were 10 patients in each group. Plasma levels of cortisol, growth ho rmone, prolactin, C-reactive protein (CRP) and interleukin-6 (IL-6) we re measured preoperatively and at fixed intervals up to 120 h postoper atively. In vitro, endotoxin stimulated whole blood tumour necrosis fa ctor alpha (TNF alpha) was measured in preoperative and 24 h postopera tive blood samples. Changes in the plasma levels of cortisol, growth h ormone and prolactin showed no statistically significant difference be tween the groups. No significant change in IL-6 levels were recorded i n any group. Changes in CRP levels were significantly higher (P < 0.00 6) in open hernia patients. Endotoxin stimulated TNF alpha production was suppressed in both groups. The degree of suppression in open herni a patients was significantly higher (P < 0.005). This study has shown that both these operations produce similar stress responses. However, open hernia operation results in a higher acute phase response and ind uces a greater endotoxin tolerance.