Surgical stress and metabolic response after totally laparoscopic right colectomy

Abstract No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and th...

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Autores principales:	Marco Milone, Antonella Desiderio, Nunzio Velotti, Michele Manigrasso, Sara Vertaldi, Umberto Bracale, Michele D’Ambra, Giuseppe Servillo, Giuseppe De Simone, Fatima Domenica Elisa De Palma, Giuseppe Perruolo, Gregory Alexander Raciti, Claudia Miele, Francesco Beguinot, Giovanni Domenico De Palma
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4c8ab5a4e9e14868a773269f5bec8b0d
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spelling	oai:doaj.org-article:4c8ab5a4e9e14868a773269f5bec8b0d2021-12-02T15:37:58ZSurgical stress and metabolic response after totally laparoscopic right colectomy10.1038/s41598-021-89183-72045-2322https://doaj.org/article/4c8ab5a4e9e14868a773269f5bec8b0d2021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89183-7https://doaj.org/toc/2045-2322Abstract No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and the metabolic response in patients who underwent right colonic resection for colon cancer. Fifty-nine patients who underwent laparoscopic resection for right colon cancer were randomized to receive an intracorporeal or an extracorporeal anastomosis (EA). Data including demographics (age, sex, BMI and ASA score), pathological (AJCC tumour stage and tumour localization) and surgical results were recorded. Moreover, to determine the levels of the inflammatory response, mediators, such as C-reactive protein (CRP), tumour necrosis factor (TNF), interleukin 1β (IL-1β), IL-6, IL-10, and IL-13, were evaluated. Similarly, cortisol and insulin levels were evaluated as hormonal responses to surgical stress. We found that the proinflammatory mediator IL-6, CRP, TNF and IL-1β levels, were significantly reduced in IA compared to EA. Concurrently, an improved profile of the anti-inflammatory cytokines IL-10 and IL-13 was observed in the IA group. Relative to the hormone response to surgical stress, cortisol was increased in patients who underwent EA, while insulin was reduced in the EA group. Based on these results, surgical stress and metabolic response to IA justify advocating the adoption of a totally laparoscopic approach when performing a right colectomy for cancer. This trial is registered on ClinicalTrials.gov (ID: NCT03422588).Marco MiloneAntonella DesiderioNunzio VelottiMichele ManigrassoSara VertaldiUmberto BracaleMichele D’AmbraGiuseppe ServilloGiuseppe De SimoneFatima Domenica Elisa De PalmaGiuseppe PerruoloGregory Alexander RacitiClaudia MieleFrancesco BeguinotGiovanni Domenico De PalmaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Marco Milone Antonella Desiderio Nunzio Velotti Michele Manigrasso Sara Vertaldi Umberto Bracale Michele D’Ambra Giuseppe Servillo Giuseppe De Simone Fatima Domenica Elisa De Palma Giuseppe Perruolo Gregory Alexander Raciti Claudia Miele Francesco Beguinot Giovanni Domenico De Palma Surgical stress and metabolic response after totally laparoscopic right colectomy
description	Abstract No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and the metabolic response in patients who underwent right colonic resection for colon cancer. Fifty-nine patients who underwent laparoscopic resection for right colon cancer were randomized to receive an intracorporeal or an extracorporeal anastomosis (EA). Data including demographics (age, sex, BMI and ASA score), pathological (AJCC tumour stage and tumour localization) and surgical results were recorded. Moreover, to determine the levels of the inflammatory response, mediators, such as C-reactive protein (CRP), tumour necrosis factor (TNF), interleukin 1β (IL-1β), IL-6, IL-10, and IL-13, were evaluated. Similarly, cortisol and insulin levels were evaluated as hormonal responses to surgical stress. We found that the proinflammatory mediator IL-6, CRP, TNF and IL-1β levels, were significantly reduced in IA compared to EA. Concurrently, an improved profile of the anti-inflammatory cytokines IL-10 and IL-13 was observed in the IA group. Relative to the hormone response to surgical stress, cortisol was increased in patients who underwent EA, while insulin was reduced in the EA group. Based on these results, surgical stress and metabolic response to IA justify advocating the adoption of a totally laparoscopic approach when performing a right colectomy for cancer. This trial is registered on ClinicalTrials.gov (ID: NCT03422588).
format	article
author	Marco Milone Antonella Desiderio Nunzio Velotti Michele Manigrasso Sara Vertaldi Umberto Bracale Michele D’Ambra Giuseppe Servillo Giuseppe De Simone Fatima Domenica Elisa De Palma Giuseppe Perruolo Gregory Alexander Raciti Claudia Miele Francesco Beguinot Giovanni Domenico De Palma
author_facet	Marco Milone Antonella Desiderio Nunzio Velotti Michele Manigrasso Sara Vertaldi Umberto Bracale Michele D’Ambra Giuseppe Servillo Giuseppe De Simone Fatima Domenica Elisa De Palma Giuseppe Perruolo Gregory Alexander Raciti Claudia Miele Francesco Beguinot Giovanni Domenico De Palma
author_sort	Marco Milone
title	Surgical stress and metabolic response after totally laparoscopic right colectomy
title_short	Surgical stress and metabolic response after totally laparoscopic right colectomy
title_full	Surgical stress and metabolic response after totally laparoscopic right colectomy
title_fullStr	Surgical stress and metabolic response after totally laparoscopic right colectomy
title_full_unstemmed	Surgical stress and metabolic response after totally laparoscopic right colectomy
title_sort	surgical stress and metabolic response after totally laparoscopic right colectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4c8ab5a4e9e14868a773269f5bec8b0d
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Surgical stress and metabolic response after totally laparoscopic right colectomy

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