Montalto Angela Simona, Impellizzeri Pietro, Grasso Maria, Antonuccio Pietro, Crisafi Caterina, Scalfari Gianfranco, Arena Francesco, Salpietro Carmelo, Lima Mario, Romeo Carmelo
Unit of Genetic and Pediatric Immunology, Department of Pediatric, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
Unit of Pediatric Surgery, Department of Pediatrics, Gynecological, Mycrobiological, and Biomedical Sciences, University of Messina, Messina, Italy.
Eur J Pediatr Surg. 2014 Apr;24(2):174-8. doi: 10.1055/s-0033-1333634. Epub 2013 Feb 26.
The transumbilical laparoscopic-assisted appendectomy (TULAA) effects on the surgical stress response in children have not been studied. Our aim is to investigate the stress response in TULAA.
A total of 35 children underwent the appendectomy by open approach (OA) or TULAA approach. Interleukins (ILs)-6, -18, and -10 were measured before (T0), at the beginning (T1a), and at the end of surgery (T1b) and 24 hours after (T2).
An increase in IL-6 levels at T1b and T2 and in IL-18 at T2 was observed after OA. A significant increase of both IL-6 and IL-18 were observed at T2 but values were less compared with OA (11.6 ± 4.4 vs. 31.9 ± 8.9 pg/mL for IL-6, p = 0.0006; 145.6 vs. 174.9 pg/mL for IL-18, p = NS).
A significant reduction in the postoperative cytokines in TULAA group suggests that this approach causes less surgical trauma in children.
经脐腹腔镜辅助阑尾切除术（TULAA）对儿童手术应激反应的影响尚未得到研究。我们的目的是调查TULAA中的应激反应。
共有35名儿童接受了开放手术（OA）或TULAA手术的阑尾切除术。在手术前（T0）、开始时（T1a）、手术结束时（T1b）以及术后24小时（T2）测量白细胞介素（ILs）-6、-18和-10。
OA术后观察到T1b和T2时IL-6水平升高，T2时IL-18水平升高。T2时观察到IL-6和IL-18均显著升高，但与OA相比数值较低（IL-6为11.6±4.4对31.9±8.9 pg/mL，p = 0.0006；IL-18为145.6对174.9 pg/mL，p =无显著性差异）。
TULAA组术后细胞因子显著降低，表明该方法对儿童造成的手术创伤较小。
