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Laparoscopic versus open appendectomy on serum levels of cytokines in children with perforated appendices, peritonitis and sepsis

Duan Xufei, Ye Guogang, Zhou Shiqiong, Mei Hong, Bian Hongqiang, Yang Jun, Yan Xueqiang

Purpose: To examine the effect of Laparoscopic (LA) and Open Appendectomy (OA) on serum levels of inflammatory factors Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory factor, Interleukin-10 (IL-10), in children with perforated appendices, peritonitis and sepsis.

Methods: 36 children received LA and 31 children received OA were included. Serum IL-6, TNF-α and IL-10 were determined at different time points before and after surgery with double-antibody sandwich ELISA.

Results: Preoperative serum IL-6, TNF-α and IL-10 were not significantly different between LA group and OA group (P>0.05). However, serum IL-6 and TNF-α in LA group were significantly lower than those in OA group on postoperative days 1, 3 and 7 (all P<0.05). Serum IL-10 in LA group was initially higher than that in OA group on postoperative days 1 and 3 (P<0.05), but became significantly lower than that in OA group on postoperative day 7 (P<0.05).

Conclusion: Decreased inflammatory response and enhanced anti-inflammatory response were evident postoperatively in children received LA reflected by reduced serum IL-6 and TNF-α, and increased serum IL-10, suggesting LA is a better choice over OA.