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

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