Martinschek A, et al. – An analysis was designed to assess in a prospective, controlled, nonrandomized study the surgical stress and acute–phase systemic response in robotic–assisted laparoscopic prostatectomy (RALP) compared to open radical retro–pubic prostatectomy (ORRP) by assessing humoral mediators. The outcomes validated that IL–6 and IL–10 are feasible objective markers for surgical stress and that tissue trauma and activation of post–aggression metabolism seem to be less in RALP compared to open radical retro–pubic prostatectomy.

Methods

• Researchers prospectively enrolled a sum of 40 consecutive patients undergoing either RALP or ORRP to evaluate the extent of systemic response.
• They collected blood samples before surgery (T1), at the time of prostatectomy (T2), at the time of wound closure (T3), and 12 h (T4), 24 h (T5), and 48 h (T6) after surgery, and assayed for interleukins (IL–6 and IL–10), C–reactive protein (CRP), and hemoglobin.
• Thereafter, a 2–sided p < 0.05 was considered to indicate significance.

Results

• In this analysis, baseline levels of IL–6, IL–10, and CRP were comparable in both arms of the study.
• The data showed that IL–6 and IL–10 increased in both groups during surgery and reached maximum levels at 12 and 24 h after surgery.
• It was noted that the RALP and RRP groups differed significantly at T2 (p = 0.009), T3 (p = 0.046), T5 (p = 0.05) and T6 (p = 0.0007) for IL–6, and at T3 (p = 0.05) and T4 (p = 0.05) for IL–10. CRP levels differed significantly at 48 h postoperative (p = 0.0053).
• They observed that the maximum levels of all 3 mediators in the RALP group were significantly lower than those in the open surgery group.
• The obtained data suggests that patients in the RALP group experienced less pain from day 2 to 4 according to the Visual Analog Scale (p < 0.05).