A randomized, prospective, blinded comparison of XXXX , metabolic response, and perceived health after laparoscopic and small incision cholecystectomy.

@entity1 @entity701 @entity158 @entity1576 @entity282 @entity1851
BACKGROUND: We have previously shown that in a randomized comparison of laparoscopic (LC) versus small incision (SC) cholecystectomy, postoperative hospital stay is comparable. This randomized prospective study compares the @entity282 , analgesic and antiemetic consumption, perceived health, and metabolic and respiratory responses after these two procedures. METHODS: Two hundred @entity1 were recruited; postoperative stay, @entity158 scores, analgesic and antiemetic consumption were recorded. Nottingham Health Profile questionnaires were completed by a subgroup of 100 @entity1 , and the metabolic and respiratory responses were also compared in a further subgroup of 20 @entity1 . RESULTS: @entity158 scores in both groups were low. LC, however, was associated with lower @entity282 scores and analgesic requirements compared with SC, but the antiemetic requirements were greater after LC. The duration of hospital stay and the perceived health after operation were the same in both groups, and both procedures were associated with a similar reduction of respiratory function. Twenty-four hours after operation the inflammatory ( @entity1851 , @entity1851 ) response to LC (22 +/- 20 mg/L) was significantly lower than after SC (68 +/- 30 mg/L), but the neuroendocrine ( @entity701 ) response was similar (LC, 475 +/- 335 nmol/L, compared with SC, 710 +/- 410 nmol/L). Independent of the technique used, the duration of postoperative hospital stay correlated significantly with the magnitude of both the 24-hour postoperative @entity701 and @entity1851 responses ( @entity701 : rs = 0.678, p < 0.001; @entity1851 : rs = 0.566, p = 0.011). CONCLUSIONS: LC appears to be associated with less tissue destruction and @entity158 than SC, but this did not confer any advantage in the degree of postoperative @entity1576 , length of hospital stay, or postoperative perceived health. The neuroendocrine component of the metabolic response evoked by each procedure was similar and had a significant correlation to @entity1 's postoperative hospital stay. This finding may explain the similar postoperative recovery after LC and SC.
