Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2022; 14(1): 234-243
Published online Jan 27, 2022. doi: 10.4254/wjh.v14.i1.234
Assessment for the minimal invasiveness of laparoscopic liver resection by interleukin-6 and thrombospondin-1
Takayoshi Kaida, Hiromitsu Hayashi, Hiroki Sato, Shotaro Kinoshita, Takashi Matsumoto, Yuta Shiraishi, Yuki Kitano, Takaaki Higashi, Katsunori Imai, Yo-ichi Yamashita, Hideo Baba
Takayoshi Kaida, Hiromitsu Hayashi, Hiroki Sato, Shotaro Kinoshita, Takashi Matsumoto, Yuta Shiraishi, Yuki Kitano, Takaaki Higashi, Katsunori Imai, Yo-ichi Yamashita, Hideo Baba, Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto 860-8556, Japan
Author contributions: Kaida T and Hayashi H identified the concept and wrote the draft of the article; Sato H, Kinoshita S, Matsumoto T, Siraishi Y, Kitano Y, Higashi T, and Imai K actually treated the patient and collected data; Yamashita Y and Baba Hsupervised article preparation.
Institutional review board statement: This study was retrospective, non-interventional, which approved by the institutional ethics committee of Kumamoto University Hospital (approval No.2052) and was performed in accordance with the Helsinki Declaration of 1975.
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: We declare that we have no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hiromitsu Hayashi, FACS, MD, PhD, Assistant Professor, Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. hhayasi@kumamoto-u.ac.jp
Received: March 27, 2021
Peer-review started: March 27, 2021
First decision: June 15, 2021
Revised: June 23, 2021
Accepted: December 11, 2021
Article in press: December 11, 2021
Published online: January 27, 2022
Abstract
BACKGROUND

Laparoscopic surgery has been introduced as a minimally invasive technique for the treatment of various field. However, there are few reports that have scientifically investigated the minimally invasive nature of laparoscopic liver resection (LLR).

AIM

To investigate whether LLR is scientifically less invasive than open liver resection.

METHODS

During December 2011 to April 2015, blood samples were obtained from 30 patients who treated with laparoscopic (n = 10, 33%) or open (n = 20, 67%) partial liver resection for liver tumor. The levels of serum interleukin-6 (IL-6) and plasma thrombospondin-1 (TSP-1) were measured using ELISA kit at four time points including preoperative, immediate after operation, postoperative day 1 (POD1) and POD3. Then, we investigated the impact of the operative approaches during partial hepatectomy on the clinical time course including IL-6 and TSP-1.

RESULTS

Serum level of IL-6 on POD1 in laparoscopic hepatectomy was significantly lower than those in open hepatectomy (8.7 vs 30.3 pg/mL, respectively) (P = 0.003). Plasma level of TSP-1 on POD3 in laparoscopic hepatectomy was significantly higher than those in open hepatectomy (1704.0 vs 548.3 ng/mL, respectively) (P = 0.009), and have already recovered to preoperative level in laparoscopic approach. In patients with higher IL-6 Levels on POD1, plasma level of TSP-1 on POD3 was significantly lower than those in patients with lower IL-6 Levels on POD1. Multivariate analysis showed that open approach was the only independent factor related to higher level of IL-6 on POD1 [odds ratio (OR), 7.48; 95% confidence interval (CI): 1.28-63.3; P = 0.02]. Furthermore, the higher level of serum IL-6 on POD1 was significantly associated with lower level of plasm TSP-1 on POD3 (OR, 5.32; 95%CI: 1.08-32.2; P = 0.04) in multivariate analysis.

CONCLUSION

In partial hepatectomy, laparoscopic approach might be minimally invasive surgery with less IL-6 production compared to open approach.

Keywords: Laparoscopic surgery, Liver resection, Hepatectomy, Minimal invasiveness, Interleukin-6, Thrombospondin-1

Core Tip: Laparoscopic liver resection is less invasive than open liver resection and is becoming more popular worldwide. However, reports that have scientifically investigated the minimally invasive nature of laparoscopic surgery remain scarce. In the current study, we scientifically evaluated the minimally invasive nature of laparoscopic surgery using interleukin-6 and thrombospondin-1 as markers of tissue damage.