Effects of serum levels of interleukin-6, tumor necrosis factor alpha and interleukin-10 between laparoscopic and open appendectomy in children with peritonitis and sepsis secondary to appendicitis perforation

Abstract

Objective To evaluate the effects of laparoscopic appendectomy (LA) and open appendectomy (OA) on serum levels of pro-inflammatory cytokine interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α) and anti-inflammatory cytokine interleukin-10 (IL-10) in children with peritonitis and sepsis secondary to appendicitis perforation.Methods A total of 67 patients were recruited to undergo either LA (n =36) or OA (n =31).The serum levels of IL-6,TNF-α and IL-10 were measured with enzyme-linked irnmunosorbent assay (ELISA) at preoperation and different timepoints postoperation.And the differences of serum levels of IL-6,TNF-α and IL-10 in laparoscopic group and open group.Results In the LA group,the pre-operative and post-operative Day 1,3 and 7 serum levels of IL-6,TNF-α and IL-10 were (148.3 ± 19.0),(81.4 ± 10.7) & (156.9 ±39.5) pg/ml,(172.7±23.2),(80.1 ±11.3) & (23.9±4.9) pg/ml,(97.3±12.7),(52.4± 9.3) & (23.7 ± 6.8) pg/ml and (215.3 ± 57.9),(145.3 ± 32.6) & (47.8 ± 8.4) pg/ml; For the OA group,(144.2±22.1),(80.5±8.9) & (156.8±42.3) pg/ml,(184.5±26.8),(135.3±19.2) &(65.2±16.4) pg/ml,(102.8±11.4),(84.5±11.7) & (48.3±9.5) pg/ml and (179.1±48.9),(114.4± 26.7) & (52.7 ± 12.3) pg/ml respectively.Their preoperative levels were not different between two groups (P＞0.05).The serum levels of IL-6 and TNF-α at Day 1,3 and 7 post-operation in the laparoscopic group were lower than those in the open group (P＜0.05).The serum levels of IL-10 at Day 1 and 3 post-operation in the laparoscopic group were higher than those in the open group (P＜0.05).At Day 7,the serum levels of IL-10 in the laparoscopic group were lower than those in the open group.However the difference had no statistical significance (P＞0.05).The rises of IL-6 and TNF-α in the laparoscopic group were remarkably less and slowly than that those in the open group.And the decline were more rapid in the laparoscopic group,the rise of IL-10 was marked while its decline was more rapid in the laparoscopic group than those in the open group.Conclusions LA can decrease the serum levels of pro-inflammatory cytokines IL-6 and TNF-α and increase the serum levels of anti-inflammatory cytokine IL-10.And it can reduce stress and inflammatory responses and enhance anti-inflammatory response for children with peritonitis and sepsis secondary to appendicitis perforation. Key words: Appendectomy; Laparoscopy; Interleukins; Tumor necrosis factor