engleski

Post-traumatic recovery in patients with laparoscopic and laparotomic surgery ; differential responses depending on the type of surgical trauma and illness

In comparison to laparotomic surgery, laparoscopy causes mild damage to the "abdominal wall" and is thus preferable both because of traumatic and of cosmetic reasons. However, it is not certain if systemic response to such mild surgical trauma differs in the pathophysiological bases from the post-traumatic response that follows more aggressive surgical treatments. Similarly, it is an open question in which respects does response to surgical trauma depend on the severity of the illness patients suffer from. In this study we monitored changes of the (un)specific markers (CRP, albumin, ALP, CK, liver transaminases, iron, transfferin and ferritin) after surgical trauma in comparison to the pre-operative values in respect to the type of surgery. It was noticed that CRP increased both after laparatomic and laparoscopic surgery applied for cholecystectomy, but to significantly higher values after laparatomy. Opposite to that, albumin values decreased, in particular in case of patients undergoing laparatomy. Such acute phase response dynamic was especially evident in cancer patients undergoing laparatomy. Enzymatic changes referred mostly and individually to the illness, not to the surgical trauma, while iron metabolism was changed in the acute and non-specific pattern showing significant reduction of the blood iron content for all the patients. Finally, the change of anti-oxLDL antibody titre appeared as individual parameter of post-traumatic oxidative stress, mostly in patients with laparatomy performed for the surgical treatment of inflammatory diseases, but not cancer. Thus, we suppose that further studies on the parameters of patients' response to surgical trauma might be useful for additional evaluation of the pathophysiology of particular illnesses as well as for the prognostic purposes. In comparison to laparotomic surgery, laparoscopy causes mild damage to the "abdominal wall" and is thus preferable both because of traumatic and of cosmetic reasons. However, it is not certain if systemic response to such mild surgical trauma differs in the pathophysiological bases from the post-traumatic response that follows more aggressive surgical treatments. Similarly, it is an open question in which respects does response to surgical trauma depend on the severity of the illness patients suffer from. In this study we monitored changes of the (un)specific markers (CRP, albumin, ALP, CK, liver transaminases, iron, transfferin and ferritin) after surgical trauma in comparison to the pre-operative values in respect to the type of surgery. It was noticed that CRP increased both after laparatomic and laparoscopic surgery applied for cholecystectomy, but to significantly higher values after laparatomy. Opposite to that, albumin values decreased, in particular in case of patients undergoing laparatomy. Such acute phase response dynamic was especially evident in cancer patients undergoing laparatomy. Enzymatic changes referred mostly and individually to the illness, not to the surgical trauma, while iron metabolism was changed in the acute and non-specific pattern showing significant reduction of the blood iron content for all the patients. Finally, the change of anti-oxLDL antibody titre appeared as individual parameter of post-traumatic oxidative stress, mostly in patients with laparatomy performed for the surgical treatment of inflammatory diseases, but not cancer. Thus, we suppose that further studies on the parameters of patients' response to surgical trauma might be useful for additional evaluation of the pathophysiology of particular illnesses as well as for the prognostic purposes.

surgical trauma ; acute phase response ; post-traumatic oxidative stress

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