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Vasc Health Risk Manag ; 12: 371-378, 2016.
Article in English | MEDLINE | ID: mdl-27713633

ABSTRACT

PURPOSE: Minimally invasive surgical techniques have been shown to reduce the inflammatory response related to a surgical procedure. The main objective of our study was to measure the inflammatory response in patients undergoing a totally laparoscopic versus open aortobifemoral bypass surgery. This is the first randomized trial on subjects in this population. PATIENTS AND METHODS: This is a substudy of a larger randomized controlled multicenter trial (Norwegian Laparoscopic Aortic Surgery Trial). Thirty consecutive patients with severe aortoiliac occlusive disease eligible for aortobifemoral bypass surgery were randomized to either a totally laparoscopic (n=14) or an open surgical procedure (n=16). The inflammatory response was measured by perioperative monitoring of serum interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP) at six different time points. RESULTS: The inflammatory reaction caused by the laparoscopic procedure was reduced compared with open surgery. IL-6 was significantly lower after the laparoscopic procedure, measured by comparing area under the curve (AUC), and after adjusting for the confounding effect of coronary heart disease (P=0.010). The differences in serum levels of IL-8 and CRP did not reach statistical significance. CONCLUSION: In this substudy of a randomized controlled trial comparing laparoscopic and open aortobifemoral bypass surgeries, we found a decreased perioperative inflammatory response after the laparoscopic procedure measured by comparing AUC for serum IL-6.


Subject(s)
Acute-Phase Reaction/prevention & control , Aortic Diseases/surgery , Arterial Occlusive Diseases/surgery , Iliac Artery/surgery , Laparoscopy/adverse effects , Vascular Surgical Procedures/adverse effects , Acute-Phase Reaction/blood , Acute-Phase Reaction/diagnosis , Acute-Phase Reaction/etiology , Aged , Aortic Diseases/diagnostic imaging , Arterial Occlusive Diseases/diagnostic imaging , Biomarkers/blood , C-Reactive Protein/metabolism , Constriction, Pathologic , Female , Humans , Iliac Artery/diagnostic imaging , Inflammation Mediators/blood , Interleukin-6/blood , Interleukin-8/blood , Male , Middle Aged , Norway , Severity of Illness Index , Time Factors , Treatment Outcome , Vascular Surgical Procedures/methods
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