Inflammatory response after laparoscopic versus open resection of colorectal liver metastases: Data from the oslo-comet trial

Abstract

Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial. This was a predefined exploratory substudy within the Oslo CoMetstudy. Forty-five patients with CLM were randomized to laparoscopic (n ¼ 23) or open (n ¼ 22) resection. Ethylenediaminetetraacetic acidplasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at 80 o C. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cellfree DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation. Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1b, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, Creactive protein, and macrophage inflammatory protein -1b, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.