The Effects of Laparoscopic Colon Surgery on Postoperative Renal Functions
PDF
Cite
Share
Request
Research
P: 310-315
September 2019

The Effects of Laparoscopic Colon Surgery on Postoperative Renal Functions

Med J Bakirkoy 2019;15(3):310-315
1. Sağlık Bilimleri Üniversitesi, Hamidiye Sağlık Bilimleri Enstitüsü, Tıbbi Biyokimya Anabilim Dalı, İstanbul, Türkiye
2. Sağlık Bilimleri Üniversitesi Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye
No information available.
No information available
Received Date: 21.06.2019
Accepted Date: 22.07.2019
Publish Date: 03.09.2019
PDF
Cite
Share
Request

ABSTRACT

Objective:

Laparoscopic colon surgery has the clinical benefits of short hospital stay, less pain after surgery and early return of intestinal function. However, hemodynamic changes may occur in the abdominal organs due to prolonged operation time and increased intra-abdominal pressure compared to open surgery.

Methods:

In this study, we compared the results of laparoscopic colon surgery with the results of open colon surgery in terms of the effects on the abdominal organs and the changes in acute phase reactants.

Results:

Patients who underwent colon surgery due to benign and malignant diseases in gastrointestinal surgery department between January 2015 and January 2018 were evaluated. Age, sex, operative time, preoperative and postoperative 24th hour blood values (neutrophil, platelet, albumin, alanine transferase, aspartate transferase, total billirubin, urea, creatinine, c-reactive protein) were compared between the two groups. Operative time in group I (open surgery) was significantly lower than group II (laparoscopic surgery) (p < 0.05). In group I, postoperative c-reactive protein (CRP) increase was significantly lower than group II (p<0.05). In group I, postop albumin decrease was significantly higher than group II (p<0.05).

Conclusion:

Although the operation time was longer in colorectal surgery, there was no significant impairment in renal and liver function in laparoscopic surgery compared to open surgery. Moreover, this study has shown that laparoscopic surgery was less traumatic than open surgery due to minimal change in albumin and CRP values.

Keywords:
Colon cancer, laparoscopic surgery, liver function, pneumoperitoneum, renal function

References

1
Gui-Ae Jeong, Gyu-Seok Cho, Eung-Jin Shin, Moon-Soo Lee, Hyung-Chul Kim, Ok-Pyung Song. Liver function alterations after laparoscopy-assisted gastrectomy for gastric cancer and its clinical significance. World J Gastroenterol 2011;17:372-8.
2
Morino M, Giraudo G, Festa V. Alterations in hepatic function during laparoscopic surgery. An experimental clinical study. Surg Endosc 1998;12:968-72.
3
Malbrain ML, Chiumello D, Pelosi P, Wilmer A, Brienza N, Malcangi V, et al. Prevalence of intra-abdominal hypertension in critically ill patients: a multicentre epidemiological study. Intensive Care Med 2004;30:822-9.
4
Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the International Conference of Experts on Intraabdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions. Intensive Care Med 2006;32:1722-32.
5
Gutt CN, Schmandra TC. Portal venous flow during CO2 pneumoperitoneum in the rat. Surg Endosc 1999;13:902-5.
6
Jakimowicz J, Stultiens G, Smulders F. Laparoscopic insufflation of the abdomen reduces portal venous flow. Surg Endosc 1998;12:129-32.
7
Schäfer M, Krähenbühl L. Surgical research review. Surgery 2001;129:385-9.
8
Cisek LJ, Gobet RM, Peters CA. Pneumoperitoneum produces reversible renal dysfunction in animals with normal and chronically reduced renal function. J Endourol 1998;12:95-100.
9
Hashikura Y, Kawaski S, Munakata Y, Hashimoto S, Hayashi K, Makuuchi M. Effects of peritoneal insufflation on hepatic and renal blood flow. Surg Endosc 1994;8:759-61.
10
Shuto K, Kitano S, Yoshida T, Bandoh T, Mitarai Y, Kobayashi M. Hemodynamic and arterial blood gas changes during carbon dioxide and helium pneumoperitoneum in pigs. Surg Endosc 1995;9:1173-8.
11
London ET, Ho HS, Neuhaus AMC, Wolfe BM, Rudich AM, Perez RV. Effect of intravascular volume expansion on renal function during prolonged CO2 pneumoperitoneum. Ann Surg 2000;231:195-201.
12
Lee JY , Choi SH. Results of hepatic and renal function tests to different CO2 pneumoperitoneum conditions: An experimental capnoperitoneum study in dogs. Res Vet Sci 2015;101:1-5.
13
Nguyen NT, Perez RV, Fleming N, Rivers R, Wolfe BM. Effect of prolonged pneumoperitoneum on intraoperative urine output during laparoscopic gastric bypass. J Am Coll Surg 195:476-83.
14
Perez J, Taura P, Rueda J, Balust J, Anglada T, Beltran J, et al. Role of dopamine in renal dysfunction during laparoscopic surgery. Surg Endosc 2002;16:1297-301.
15
Bickel A, Weiar A, Eitan A. Evaluation of liver enzymes following elective laparoscopic cholecystectomy: are they really elevated? J Gastrointest Surg 2008;12:1418-21.
16
Jeong GA, Cho GS, Shin EJ, Lee MS, Kim HC,  Song OP. Liver function alterations after laparoscopy-assisted gastrectomy for gastric cancer and its clinical significance. World J Gastroenterol 2011;17:372-8.
17
Grande M, Tucci GF, Adorisio O, Barini A, Rulli F, Neri A, et al. Systemic acute-phase response after laparoscopic and open cholecystectomy. Surg Endosc 2002;16:313-6.
18
Cruickshank AM, Fraser WD, Burns HJ, Van Damme J, Shenkin A. Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci 1990;79:161-5.
19
Kim JS, Hur H, Min BS, Lee KY, Chung HC, Kim NK. Inflammatory and Tumor Stimulating Responses after Laparoscopic Sigmoidectomy. Yonsei Med J 2011;52:635-42.
20
Leung KL, Lai PB, Ho RL, Meng WC, Yiu RY, Lee JF, et al. Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: a prospective randomized trial. Ann Surg 2000;231:506-11.
21
Delgado S, Lacy AM, Filella X, Castells A, García-Valdecasas JC, Pique JM, et al. Acute phase response in laparoscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 2001;44:638-46.
22
Doğan U , Habibi M , Bülbüller N , Ellidağ HY , Mayir B , Çakır T, et al. Effects of different intraabdominal pressure levels on oxidative stress markers in laparoscopic cholecystectomy. Turk J Surg 2018;34:212-6.
23
Koksal H, Kurban S. Total oxidant status, total antioxidant status, and paraoxonase and arylesterase activities during laparoscopic cholecystectomy. Clinics 2010;65:285-90.
24
Koksal H, Kurban S, Şahin M. The role of ischemia modified albumin in the evaluation of hemodynamic changes in the splanchnic area during laparoscopic cholecystectomy. Ulus Cerrahi Derg 2010;26:91-4.