A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy

Renato A. Luna, Daniel B. Nogueira, Pablo S. Varela, Eduardo De O. Rodrigues Neto, Maria Júlia R. Norton, Luciana Do Carmo B. Ribeiro, Agatha M. Peixoto, Yara L. De Mendonça, Isidro Bendet, Rossano A. Fiorelli, James P. Dolan

Research output: Contribution to journalReview article

42 Scopus citations

Abstract

Background: The purpose of this study was to compare the postoperative inflammatory response and severity of pain between single-incision laparoscopic surgery (SILS) cholecystectomy and conventional laparoscopic cholecystectomy (LC). Methods: Two groups of 20 patients were prospectively randomized to either conventional LC or SILS cholecystectomy. Serum interleukin-6 (IL-6) levels were assayed before surgery, at 4-6 h, and at 18-24 h after the procedure. Serum C-reactive protein (CRP) levels also were assayed at 18-24 h after surgery. Pain was measured at each of three time points after surgery using the visual analogue scale (VAS). The number of analgesia doses administered in the first 24 h after the procedure also was recorded and 30-day surgical outcomes were documented. Results: The groups had equivalent body mass index (BMI), age, and comorbidity distribution. Peak IL-6 levels occurred 4-6 h after surgery, and the median level was 12.8 pg/ml in the LC and 8.9 pg/ml in the SILS group (p = 0.5). The median CRP level before discharge was 1.6 mg/dl in the LC and 1.9 mg/dl in the SILS group (p = 0.38). There was no difference in either analgesic use or pain intensity as measured by the VAS between the two groups (p = 0.72). The length of the surgical procedure was significantly longer in the SILS group (p < 0.001). No intraoperative complications occurred in either group. Conclusions: Single-incision laparoscopic surgery does not significantly reduce systemic inflammatory response, postoperative pain, or analgesic use compared with LC.

Original languageEnglish (US)
Pages (from-to)1254-1259
Number of pages6
JournalSurgical endoscopy
Volume27
Issue number4
DOIs
StatePublished - Apr 2013

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Keywords

  • Inflammatory response
  • Laparoscopy
  • Postoperative pain
  • SILS
  • Single incision
  • Single port

ASJC Scopus subject areas

  • Surgery

Cite this

Luna, R. A., Nogueira, D. B., Varela, P. S., De O. Rodrigues Neto, E., Norton, M. J. R., Do Carmo B. Ribeiro, L., Peixoto, A. M., De Mendonça, Y. L., Bendet, I., Fiorelli, R. A., & Dolan, J. P. (2013). A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy. Surgical endoscopy, 27(4), 1254-1259. https://doi.org/10.1007/s00464-012-2589-5