Salivary Chromogranin A as a Psychosomatic Stress Marker Is Suppressed in Laparoscopic Surgery Compared with Open Surgery for Colon Cancer

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  • ISHIYAMA SHUN
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • SAKAMOTO KAZUHIRO
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • KAMIYAMA HIROHIKO
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • NIWA KOICHIRO
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • SUGIMOTO KIICHI
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • TAKAHASHI MAKOTO
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • KOJIMA YUTAKA
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • GOTO MICHITOSHI
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • OKUZAWA ATSUSHI
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine
  • TOMIKI YUICHI
    Department of Coloproctological Surgery, Juntendo University Faculty of Medicine

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Abstract

<p>Objective: The advantages of laparoscopic surgery have been described in previous studies. The aim of this study was to objectively evaluate the benefits of laparoscopic surgery (LS) vs. conventional open surgery (OS) by measuring stress markers.</p><p>Materials: Fifty-four patients who underwent radical resection for primary colon cancer between May 2008 and March 2011 were enrolled. Thirty-two of the 54 patients underwent LS and twenty-two underwent OS.</p><p>Methods: Peripheral blood and saliva samples were obtained on five occasions during the perioperative period. Salivary Chromogranin A (CgA), derivatives of Reactive Oxygen Metabolite Test (d-ROMs Test), interleukin 6 (IL-6), natural killer (NK) cell activity and C-reactive protein (CRP) levels were analyzed for comparison between the two groups.</p><p>Results: With respect to the clinical characteristics, the intraoperative blood loss was significantly lower, and the operating time was longer in the LS group. Early postoperative oral-intake and reduced postoperative hospitalization were observed in the LS group. The salivary CgA, serum IL-6, and CRP were significantly lower in the LS group compared with the OS group. There was no difference in the d-ROMs finding between the two groups.</p><p>Conclusions: In the present study, there were significant differences in postoperative oral in-take, postoperative hospitalization, IL-6, CRP, and salivary CgA, suggesting an advantage of LS for patients with colon cancer. With respect to our finding of perioperative salivary CgA, further studies will be necessary to demonstrate the significance of this interesting and promising test.</p>

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