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Sekhon V, Menon P, Arora S, et al. Nephrectomy in children: Comparison of stress response to laparoscopic and open methods. J Indian Assoc Pediatr Surg. 2013;18(2):53-7doi: 10.4103/0971-9261.109352.
Sekhon, V., Menon, P., Arora, S., & Rao, K. L. (2013). Nephrectomy in children: Comparison of stress response to laparoscopic and open methods. Journal of Indian Association of Pediatric Surgeons, 18(2), 53-7. https://doi.org/10.4103/0971-9261.109352
Sekhon, Virender, et al. "Nephrectomy in children: Comparison of stress response to laparoscopic and open methods." Journal of Indian Association of Pediatric Surgeons vol. 18,2 (2013): 53-7. doi: https://doi.org/10.4103/0971-9261.109352
Sekhon V, Menon P, Arora S, Rao KL. Nephrectomy in children: Comparison of stress response to laparoscopic and open methods. J Indian Assoc Pediatr Surg. 2013 Apr;18(2):53-7. doi: 10.4103/0971-9261.109352. PMID: 23798806; PMCID: PMC3687146.
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J Indian Assoc Pediatr Surg. 2013 Apr;18(2):53-7. doi: 10.4103/0971-9261.109352.

Nephrectomy in children: Comparison of stress response to laparoscopic and open methods.

Journal of Indian Association of Pediatric Surgeons

Virender Sekhon, Prema Menon, Sunil Arora, K L N Rao

Affiliations

  1. Department of Pediatric Surgery, Advanced Pediatric Center, Chandigarh, India.

PMID: 23798806 PMCID: PMC3687146 DOI: 10.4103/0971-9261.109352

Abstract

AIM: To evaluate and compare the extent of surgical stress following laparoscopic nephrectomy (LN) and open nephrectomy (ON) in children.

MATERIALS AND METHODS: Twenty consecutive children undergoing nephrectomy were randomized to LN or ON groups. Acid-base balance, blood glucose, acute phase proteins (C-reactive protein [CRP]) and inflammatory markers (interleukin-6 [IL-6]) were measured pre-operatively, as well as 4 and 24 h after surgery. The differences between the two groups were analyzed statistically (significance value for P < 0.05).

RESULTS: The overall acid base status was more stable in LN. The fall in pH 4 h after surgery was more in ON (P = 0.440) and the difference in pH in ON 4 h and 24 h post-operatively was statistically significant (P = 0.002). In LN, significant difference was found in the base excess mean pre-surgery (mean -3.280 mEq/L) and 4 h post-surgery (mean -7.480 mEq/L) (P = <0.05), as well as between 4 h and 24 h after surgery (mean -2.660 mEq/L) (P = 0.011). The acute rise in CRP 24 h post-operatively in the ON (88.972 mg/L) was significantly higher when compared to both the pre-operative and 4 h post-operative values (P < 0.05). This rise was however, not statistically significant when compared to the 24 h post-operative value in LN (46.399 mg/L) (P = 0.062). The rise in IL-6, 24 h post-procedure in LN (mean 44.444 pg/ml) was statistically lower than that in the open group (mean 343.333 pg/ml) (P = 0.041).

CONCLUSIONS: The stable acid-base status and lesser rise of CRP and IL-6 in LN lead to the conclusion that surgical stress caused by LN is less than ON.

Keywords: Children; laparoscopic nephrectomy; open nephrectomy; stress response

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