Elsevier

Journal of Gastrointestinal Surgery

Volume 7, Issue 6, September–October 2003, Pages 783-790
Journal of Gastrointestinal Surgery

Influence of postoperative acute-phase responseon angiogenesis and tumor growth: open vs. laparoscopic-assisted surgery in mice

https://doi.org/10.1016/S1091-255X(03)00111-2Get rights and content

Abstract

Inflammatory responses and tumor growth are increased after laparotomy compared with laparoscopy in some animal models. Proinflammatory cytokines interleukin-6 (IL-6) and interleukin-1 beta (IL-1β) upregulate the expression of vascular endothelial growth factor (VEGF). Our aim was to investigate the influence of postoperative inflammatory responses on angiogenesis and tumor growth. 5×106 B51LiM cells were injected into the cecal wall of Balb/c mice. After 2 weeks, the animals were randomized into the following three groups: open cecectomy (OC), CO2–laparoscopic-assisted cecectomy (LC), and helium–laparoscopic-assisted cecectomy (LH). On postoperative day 12, the mice were killed. Tumor load scores and weight were significantly greater after laparotomy than after laparoscopy. Serum IL-6 levels 6 hours after surgery (OC: 4157±1297 pg/ml vs. LC: 2514±1417 pg/ml vs. LH: 2255±1714 pg/ml) and VEGF levels on postoperative day 12 (OC: 231±125 pg/ml vs. LC: 45±9 pg/ml vs. LH: 49±8 pg/ml), measured by enzyme-linked immunosorbent assay, were significantly higher in the laparotomy group. Microvessel density was also significantly higher in the OC group (OC: 34.3±11.5 vs. LC: 15.5±12.5 vs. LH: 18.5±11.9). There was a positive correlation between IL-6 and VEGF postoperative serum levels (rho = 0.67; P<0.001). We concluded that increased systemic levels of proinflammatory cytokines and VEGF are associated with increased angiogenesis and tumor growth after laparotomy compared to laparoscopy in mice.

Keywords

Laparoscopy
angiogenesis
colon cancer
IL-6
IL-1β
VEGF

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Presented at the Fifty-Seventh Annual Sessions of the Owen H. Wangensteen Surgical Forum, The American College of Surgeons Clinical Congress, San Francisco, California, October 6–10, 2002; and published as an abstract in Journal of the American College of Surgeons 2002;195:S69.

Supported by an International Fellowship Grant from the American Society of Colon and Rectal Surgeons (M.P.) and by a Postdoctoral Grant (EX2001-35105008) from the Ministry of Education and Culture of Spain.

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