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Metabolic responses after laparoscopic or open hernia repair.

Author(s): Schrenk P, Bettelheim P, Woisetschlager R, Rieger R, Wayand WU

Affiliation(s): Second Department of Surgery and Ludwig Boltzmann Institute for Surgical Laparoscopy, AKH Linz, Krankenhausstrasse 9, A-4020 Linz, Austria.

Publication date & source: 1996-06, Surg Endosc., 10(6):628-32.

Publication type: Clinical Trial; Randomized Controlled Trial

BACKGROUND: The purpose of a prospective randomized study was to compare the surgical trauma in patients undergoing laparoscopic or open hernia repair. METHODS: Postoperative pain, analgesic consumption, and metabolic response to surgery were assessed in 30 patients undergoing laparoscopic (group 1; n = 15) or open (group II; n = 15; Shouldice repair) unilateral inguinal hernia repair. Both groups were comparable with respect to age, sex, and type and size of inguinal hernia. RESULTS: Postoperative visual analogue scales (VAS) for pain were reduced on mobilization for patients of group I with a significant difference (P = 0.02) on the operative day, whereas pain scores at rest and analgesic requirements were similar for both groups. No differences between groups I and II were found in postoperative levels of interleukin-1, interleukin-6, tumor necrosis factor alpha, C-reactive protein, fibrinogen, transferrin, alpha-1-antitrypsin, and white blood cells. Postoperative polymorphonuclear (PMN) elastase concentrations remained within normal range in group II but showed a significant increase in patients operated laparoscopically for postoperative days 1 and 2. CONCLUSIONS: No major surgical trauma was found after herniorraphy compared to open hernia repair.

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