LAPAROSCOPIC RESECTION OF COLORECTAL LIVER METASTASES DOESN’T INFLUENCE INFLAMMATORY MEDIATORS: PROSPECTIVE OPEN VS LAPAROSCOPIC TRIAL

Background: Laparoscopic surgery is thought to reduce the postoperative immunologic effects of surgical trauma. The aim of the present study was to evaluate the influence of surgical trauma on inflammatory mediators. Methods: Forty patients with resectable liver metastases of colorectal origin were assigned to laparoscopic liver resection (LLR; n=22) or conventional open liver resection (OLV; n=18). Blood samples were drawn preoperatively and 24 hours after resection. Commercially available ELISA methods were used for the determination of IL-6 and IL-8. From 25 patients (LLR n=10 and OLR n=15), the mRNA of inflammation related factors (COX-2 and MMP-9), angiogenesis related factor VEGF and HIF-1 in tumor tissue and normal liver parenchyma were detected by real-time RT-PCR. Results: There were no differences in IL-6 and IL-8 levels before resection between the open and laparoscopic technique; IL-6 levels were significantly elevated in both groups at 24 hours compared to preoperative levels (p=0.028 and p=0.012, respectively). IL-8 levels were also increased at 24 hours in both groups, although not significantly. The expression of COX-2, MMP-9, VEGF and HIF-1 mRNA was not different between LLR and OLR as well as for tumor tissue as for normal liver parenchyma. Conclusions: Immunological effects assessed by IL 6, IL 8, Cox 2, MMP-9, VEGF and HIF-1a are similar between open and laparoscopic procedures. Laparoscopic approach does not reduce the surgical stress in patients suffering from colorectal liver metastases.