Abstract
BackgroundLaparoscopic Surgery has become a worldwide standard procedure for a variety of indications. This has been attributed to a milder postoperative inflammatory response by the innate immune system potentially mediated through immune mediators released by the visceral adipose tissue (VAT). However, an in vivo experimental evidence is lacking and is the issue of our present study.MethodsMale Wistar rats (N = 24) underwent standardized surgical procedures of conventional cecum resection (CCR), conventional sham operation, laparoscopic cecum resection (LCR), or laparoscopic sham operation. Cytokine expression of leptin, resistin, and IL-6 was analyzed in VAT before and after resection by quantitative RT-PCR.ResultsPostoperative leptin gene expression was reduced in the CCR and LCR groups, while expression was not significantly affected in both sham groups compared to the preoperative levels. In contrast, IL-6 expression was not affected in the LCR group, but was significantly elevated in the CCR cohort. The IL-6 expression was significantly higher in CCR compared to LCR. Resistin expression levels did not differ between all groups.ConclusionsOur study underlines the role of immunological involvement of VAT in the postoperative phase. Low leptin levels seem to act as a stimulator for energy uptake in order to cope with postoperative stress. A lower IL-6 expression in the LCR compared to the CCR group may indicate a weaker inflammatory activity potentially adding to the clinical benefits observed in patients undergoing LS.
Highlights
Laparoscopic Surgery has become a worldwide standard procedure for a variety of indications
It acts by binding to obesity receptors (ObR), which are widely expressed in the hypothalamus and cerebellum [15]
We found a significant decrease of leptin expression in visceral adipose tissue (VAT) 24 h after cecum resection in CCR and laparoscopic cecum resection (LCR) animals compared to the preoperative levels
Summary
Laparoscopic Surgery has become a worldwide standard procedure for a variety of indications. This has been attributed to a milder postoperative inflammatory response by the innate immune system potentially mediated through immune mediators released by the visceral adipose tissue (VAT). Laparoscopic procedures have become standard in general surgery with numerous clinical advantages such as a faster postoperative recovery, a shorter hospital stay and reduced postoperative pain. In colorectal surgery a reduction of postoperative morbidity leading to faster recovery has been described [1,2,3]. Intestinal motility, for example, has been shown to be substantially impaired by the inflammatory response subsequent to abdominal surgery. We sought to test the hypothesis whether or not the transcriptional output of VAT diverges after open or minimally invasive intestinal surgical interventions [10]
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