Inflammatory response after laparoscopic and conventional colorectal resections - results of a prospective randomized trial

Background: Short-term benefits of laparoscopic relative to conventional co lorectal resections have been demonstrated in randomized controlled trials. It has been suggested that a diminished cytokine and acute-phase response may be responsible for these advantages. il Methods: In a randomized contro lled trial, patients underwent laparoscopic (n=30) or conventional (n=30) r esection of colorectal tumors. Plasma levels of interleukin-l receptor anta gonist (IL-IRA), interleukin-6 (IL-6), interleukin-10 (IL-10), and C-reacti ve protein (CRP) were analyzed repeatedly. Postoperative peak levels and ar ea under the curve values were calculated and compared between groups using the Mann-Whitney U-test. Results: Patient characteristics, preoperative cy tokine, and CRP plasma levels were not different between each group. Postop erative peak concentrations of IL-6 (P=0.05) and CRP (P<0.001) and the over all postoperative plasma concentrations of IL-6 (P=0.03) and CRP (P=0.002) were lower in the laparoscopic than in the conventional group. Peak and ove rall IL-1RA (P=0.2; P=0.2) and LL-IO (P=0.4; P=0.6) plasma concentrations, respectively, were not different between groups. Conclusions: IL-6 and CRP plasma levels were lower after laparoscopic than conventional colorectal re sections. The less intense inflammatory response may be an indicator of the milder surgical trauma inflicted by laparoscopic than conventional colorec tal resection.