Length of laparotomy incision and surgical stress assessed by serum IL-6 level

SummaryBackgroundBecause surgical stress is thought to have an effect on morbidity, mortality, and remnant tumour progression after surgery, diminishing surgical stress is important. The purpose of this study was to assess in a murine model whether the length and type of laparotomy incision influence surgical stress.MethodsSerum IL-6 concentrations were measured sequentionally in 220 male BALB/c mice who were assigned to different basic laparotomies, (1-cm versus 2-cm versus 3-cm laparotomy with or without caecal resection), other types of laparotomy (3-cm, 1-cm × 3, 3-cm transverse, 3-cm laparotomy with rapid closure), or 3-cm skin incision with or without laparotomy. The serum level of IL-6 was measured by ELISA.ResultsSerum IL-6 levels at 3 and 6 h after surgery were significantly higher in the 3-cm laparotomy group (1680 ± 802 pg/ml and 1066 ± 507 pg/ml, respectively), than in the 1-cm laparotomy group (797 ± 427 pg/ml and 515 ± 212 pg/ml, respectively). When caecal resection was added, the serum IL-6 level at 6 h was significantly higher in the 3-cm laparotomy group (2844 ± 134 pg/ml) than in the 1-cm laparotomy group (2200 ± 379 pg/ml). Although the type of laparotomy incision was not associated with the serum level of IL-6, the serum IL-6 level after midline skin incision without laparotomy (245 ± 142 pg/ml) was significantly lower than that after 3-cm laparotomy (1680 ± 802 pg/ml).ConclusionsThe length of laparotomy incision was correlated with the serum level of IL-6 in a murine model. The surgical stress related to abdominal procedures might be decreased when laparotomy wounds are kept as small as possible.