SYSTEMIC STRESS RESPONSES AFTER LAPAROSCOPIC OR OPEN HERNIA REPAIR

Abstract

The purpose of this prospective randomized study was to investigate and compare the systemic stress responses after endoscopic and open hernia repair. Systemic stress responses are related to the degree of tissue trauma. It is considered that endoscopic operations are less traumatic than open operations. There were 28 patients (14 patients undergoing endoscopic total extraperitoneally and14 patients undergoing open abdominal surgery) in this study. Venous blood samples were taken before operation, peroperative and 2, 24 and 48 hours after operation. Glucose, cortisol, malonyldialdehyd (MDA), CRP, CPK, ceruloplasmine, transferrin, albumin, leukocyte, neutrophyl and lymphocyte were analysed. In both groups, the glucose and cortisol concentration increased significantly after operation. There was no significant difference in both groups. CRP, MDA and CPK increased significantly in both groups after operation. This increase was significantly higher in the open group. No significance was found between preoperative and postoperative values and groups for concentrations ceruloplasmin and transferrin. Albumin levels were significantly decreased in both groups. There were nosignificant differences between the two groups. Leukocyte on neutrophyl counts were increased significantly after operation. This increasing was significantly higher in the open group. Lymphocyte counts were decreased in both groups after operation. This decrease was significantly higher in the open group. These findings demonstrated that endoscopic surgery causes less systemic stress response than open conventional surgery.