Adipocytokine: A new family of inflammatory and immunologic markers of invasiveness in major urologic surgery

Abstract

Background: Laparoscopic surgery has been proposed to reduce surgical trauma and diminish patients' stress response. Objective: To investigate the role of the adipocytokine, in combination with changes in other known inflammatory markers, in patients undergoing radical prostatectomy. Design, setting, and participants: A total of 580 patients were enrolled in this prospective study. Laparoscopic extraperitoneal radical prostatectomy (LRP) was performed in 286 patients, and open retropubic radical prostatectomy (RRP) in 294 patients. Intervention: Blood samples were collected preoperatively and up to 5 d postoperatively. Measurements: Serum concentrations of acute phase markers, interleukins (IL), and the adipocytokine leptin were measured at each time point by means of enzyme-linked immunosorbent assay. Clinical data were collected and analysed. Results and limitations: Patients undergoing LRP had significantly lower IL-6 and adipocytokine levels at all measurement time points. However, biphasic kinetics of adipocytokine serum levels were observed during the postoperative course in all patients. LRP was associated with less adipocytokine and IL-6 release, indicating a smaller degree of surgical insult and the minimal invasive nature of this procedure. The limitation of this study was its nonrandomised design. Conclusions: Adipocytokines might serve as additional immunologic markers of invasiveness in major urologic surgery. © 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.