The systemic inflammatory response was normalized before or on the seventh postoperative day .
Conclusions Hernia repair elicits a systemic inflammatory response characterized by an increase in CRP , IL-6 , leukocytes , neutrophils , IL-1 , IL-10 , fibrinogen , and α1-antitrypsin and a decrease in lymphocytes and albumin .
A higher inflammatory response was found after mesh repair compared with non-mesh repair and after open mesh repair compared with laparoscopic mesh repair
Purpose All surgical procedures elicit a complex systemic inflammatory response effectuated and modulated by cytokines .
The purpose of this systematic review was to present an overview of the inflammatory response and the serum markers associated with hernia repair and to compare the response between patients treated with and without mesh .
Systemic inflammatory response after endoscopic (TEP) vs Shouldice groin hernia repair
Endoscopic techniques are commonly used for many different types of surgery . It is cl aim ed that videoendoscopic procedures have the advantage of being less traumatic and of offering higher postoperative patient comfort than conventional open techniques . The extent of tissue trauma can be evaluated on the basis of the inflammatory response observed in the wake of surgery . Available studies that have compared endoscopic and conventional techniques suggest that endoscopic cholecystectomy , laparoscopic colorectal resection , and thoracoscopic pulmonary resection have immunologic advantages over conventional approaches . The objective of this prospect i ve study was to determine whether endoscopic hernia repair techniques are also preferable to conventional procedures and to what extent the anesthetic technique ( local or general anesthesia ) influences the postoperative inflammatory response . For this purpose , biochemical monitoring of cytokine activity [ C-reactive protein ( CRP ) , prostagl and in F1α ( PGF1α ) , neopterin , interleukin-6 ( IL-6 ) ] was done prospect ively in 101 patients [ totally extraperitoneal approach ( TEP ) n=32 , unilateral n=12 , bilateral n=20 ; Shouldice n=69 , local anesthesia ( LA ) n=23 , general anesthesia ( GA ) n=46 ] before and until 3 days after surgery . The parameters IL-6 and PGF1α suggested that the immune trauma immediately after surgery was significantly higher in the group of patients with endoscopic hernia repair than in the group of patients who received a Shouldice repair . No significant differences were observed after the first postoperative day . A comparison between the TEP group and the patients who received conventional surgery under local anesthesia showed that the TEP approach was also associated with a higher postoperative neopterin level . Within the first 3 days after surgical intervention , bilateral endoscopic hernia repair induced no significantly higher inflammatory response than the surgical treatment of unilateral conditions . The anesthetic procedure that was used in the Shouldice operation had no significant effect on inflammatory response . Unlike other types of endoscopic surgery , the repair of groin hernias using an endoscopic technique can not be regarded as a minimally invasive procedure that is less traumatic than conventional approaches . Instead , the conventional Shouldice procedure appears to cause the lowest inflammatory response and to be the least traumatic approach to hernia repair , especially when it is performed under local anesthesia
The systemic inflammatory response was normalized before or on the seventh postoperative day .
Conclusions Hernia repair elicits a systemic inflammatory response characterized by an increase in CRP , IL-6 , leukocytes , neutrophils , IL-1 , IL-10 , fibrinogen , and α1-antitrypsin and a decrease in lymphocytes and albumin .
A higher inflammatory response was found after mesh repair compared with non-mesh repair and after open mesh repair compared with laparoscopic mesh repair
Purpose All surgical procedures elicit a complex systemic inflammatory response effectuated and modulated by cytokines .
The purpose of this systematic review was to present an overview of the inflammatory response and the serum markers associated with hernia repair and to compare the response between patients treated with and without mesh .