Abstract
Background and objectivesLaparoscopic colorectal surgery causes a lower stress response than open surgery. Adiponectin is mainly derived from adipocytes and has antidiabetic, antioxidative, and anti-inflammatory capabilities. The objective of the present study was to investigate the protein expression of adiponectin in adipose tissue, and the serum levels of adiponectin, oxidative stress markers and proinflammatory factors during laparoscopic colorectal surgery and open surgery periods.MethodsForty patients aged 60 to 80, with American Society of Anesthesiologists (ASA) I ~ II who underwent radical resection of colorectal cancer were recruited to the study. Laparoscopic group and open group included 20 patients each. Mesenteric adipose tissue and venous blood before (T1) and at the end (T2) of surgery were collected to examine adiponectin levels, and venous blood was collected to examine serum levels of oxidative stress related markers (superoxide dismutase (SOD), glutathione (GSH), lipid peroxide (LPO), malondialdehyde (MDA)), and inflammation-related factors (interleukin (IL)-1β, interleukin (IL)-6, tumor necrosis factor-α (TNF-α)).ResultsProtein and serum levels of adiponectin were analyzed, and adiponectin levels were significantly increased at T2 than T1 in the laparoscopic surgery, while adiponectin levels were significantly higher in the laparoscopic surgery than in the open surgery at T2. In addition, the serum levels of SOD and GSH were significantly higher in the laparoscopic surgery than in open surgery at T2. However, the serum levels of LPO, TNF-α, IL-1β, and IL-6 were significantly lower in the laparoscopic group than in open group at T2.ConclusionLaparoscopic surgery induced higher levels of adiponectin in both adipose tissue and the bloodstream. Oxidative stress and the inflammatory response were lower during laparoscopic colorectal surgery than during conventional open surgery. These data suggest that adipose tissue may alleviate the stress response during laparoscopic surgery by releasing adiponectin in patients with colorectal cancer.
Highlights
Colorectal cancer has attracted in recent years increasing attention because of its high morbidity and mortality, and radical resection of colorectal cancer remains the most effective treatment [1]
There was no significant difference between groups concerning age, sex, body mass index (BMI), or hospital stay after the surgery
The present study shows that the protein expression levels of adiponectin in mesenteric adipose tissue are significantly upregulated accompanied by an increase in serum adiponectin levels during laparoscopic colorectal surgery than conventional open surgery
Summary
Colorectal cancer has attracted in recent years increasing attention because of its high morbidity and mortality, and radical resection of colorectal cancer remains the most effective treatment [1]. Pappas-Gogos et al reported that laparoscopic colorectal surgery was associated with lower oxidative stress than open surgery by examining oxidative stress markers including 8-hydroxyguanosine, 8-isoprostanes, protein carbonyl, and 3-nitrotyrosine [7]. A previous study indicated that rectal surgery caused the release of pro- and anti-inflammatory cytokines, and there was a lower inflammatory response during the laparoscopic surgery than open surgery [8]. No studies have shown the possible regulatory factors associated with the reductions in the inflammatory response and oxidative stress during laparoscopic surgery. Laparoscopic colorectal surgery causes a lower stress response than open surgery. The objective of the present study was to investigate the protein expression of adiponectin in adipose tissue, and the serum levels of adiponectin, oxidative stress markers and proinflammatory factors during laparoscopic colorectal surgery and open surgery periods
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