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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2023
vol. 18
 
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Pediatric surgery
abstract:
Original paper

Can serum soluble urokinase plasminogen activator receptor be an effective biomarker in comparing the inflammatory response between laparoscopic and open appendectomy?

Basak Erginel
1
,
Meltem Savran Karadeniz
2
,
Secil Yuksel
1
,
Hayriye Senturk Ciftci
3
,
Demet Izgi
3
,
Cenk Ersavas
4
,
Erbug Keskin
1
,
Feryal Gun Soysal
1

  1. Department of Pediatric Surgery, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
  2. Department of Anesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
  3. Department of Biology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
  4. Department of General Surgery, Arel University, Istanbul, Turkey
Videosurgery Miniinv 2023; 18 (2): 351–357
DOI: https://doi.org/10.5114/wiitm.2023.128681
Online publish date: 2023/06/15
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Introduction
The inflammatory response after laparoscopy and laparotomy has been compared in studies in adults, but only a few studies have compared the immune response between laparoscopy and laparotomy in children.

Aim
To compare open and laparoscopic appendectomies regarding a new biomarker, suPAR, to evaluate the inflammatory response.

Material and methods
Patients between 3 and 17 years of age who were admitted to the pediatric surgery department and scheduled for appendectomy due to appendicitis were enrolled in the investigation. The patients were randomized to receive either laparoscopic (n = 20) or conventional open appendectomy (n = 20). The primary outcome was a change in preoperative and postoperative suPAR levels. The secondary outcomes were the white blood cell count, lymphocytes, neutrophils, platelets, C-reactive protein level, appendix diameter, symptoms, symptom duration, surgical complications, operative time, rescue analgesics, hospital stay, and family satisfaction.

Results
The mean age of the patients undergoing laparoscopic appendectomy was 10.55 ±2.743 (3–17) years. The mean age of the patients undergoing open appendectomy was 11.40 ±3.515 (3–17) years. A statistically significant difference was found when the postoperative suPAR values between the two groups were compared (p = 0.048). The operative time and hospital stay in the laparoscopic group were significantly shorter than those in the open group (p = 0.001, p = 0.047).

Conclusions
Laparoscopic appendectomy is associated with a shorter operative time, a shorter hospital stay, and a smaller inflammatory response caused by surgical stress than open appendectomy. suPAR is an effective marker for comparing postoperative inflammatory stress between open and closed appendectomies.

keywords:

laparoscopic appendectomy, soluble urokinase plasminogen activator receptor, inflammatory response
  
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