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Evaluation of some cellular biomarker proteins, oxidative stress and clinical indices as results of laparoscopic appendectomy for perforated appendicitis in children
Corresponding Author(s) : Qiang Liu
Cellular and Molecular Biology,
Vol. 66 No. 3: Issue 3
Abstract
Laparoscopic appendectomy for perforated appendicitis in children has the advantages of quick recovery, little influence of inflammatory and oxidative stress and low infection rate. Altogether 115 children with perforated appendicitis treated in our hospital from June 2018 to August 2019 were selected and divided into two groups according to different treatment methods. Laparoscopic appendectomy was used as the research group (RG) (67 cases) and open appendectomy (48 cases) as the control group (CG). The clinical indexes (operation time, intraoperative blood loss, ambulation time, incision length, postoperative exhaust time and length of stay) of the two groups were observed. The levels of C- reactive protein (CRP), procalcitonin (PCT), interleukin -6 (IL-6) and tumor necrosis factor-α (TNF-α) before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA). The levels of oxidative stress factors (superoxide dismutase (SOD), malondialdehyde (MDA)) and the incidence of postoperative incision infection were observed in the two groups. A visual analogue scale (VAS) score was used to evaluate the postoperative pain in children. Logistic regression analysis was used to analyze the risk factors of postoperative incision infection in children. The improvement degree of clinical indicators in RG was significantly better than that in CG. The expression levels of CRP, PCT, IL-6 and TNF-α in RG were significantly lower than those in CG. The expression levels of SOD and MDA in RG were significantly better than those in CG. The postoperative incision infection rate in RG was significantly lower than that in CG. The postoperative VAS score in RG was significantly lower than that in CG. Logistic regression analysis results showed that the risk of incision infection was increased in children with operation time over 1h, incision length >3cm, high CRP, high PCT, high IL-6, high TNF-α, high SOD and low MDA. Laparoscopic appendectomy for perforated appendicitis in children can effectively reduce intraoperative hemorrhage, postoperative pain, and the damage to the body of children, and can also reduce oxidative stress and inflammatory reaction in children.
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- Bolmers MD, van Rossem CC, Gorter RR, Bemelman WA, van Geloven AAW, Heij HA and Snapshot Appendicitis Collaborative Study g. Imaging in pediatric appendicitis is key to a low normal appendix percentage: a national audit on the outcome of appendectomy for appendicitis in children. Pediatr Surg Int 2018; 34: 543-551.
- Baxter KJ, Nguyen H, Wulkan ML and Raval MV. Association of Health Care Utilization With Rates of Perforated Appendicitis in Children 18 Years or Younger. JAMA Surg 2018; 153: 544-550.
- Li HM, Liu SZ, Huang YK, Su YC and Kao CH. Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study. Int J Environ Res Public Health 2018; 15:
- Hutchings N, Wood W, Reading I, Walker E, Blazeby JM, Van't Hoff W, Young B, Crawley EM, Eaton S, Chorozoglou M, Sherratt FC, Beasant L, Corbett H, Stanton MP, Grist S, Dixon E and Hall NJ. CONTRACT Study - CONservative TReatment of Appendicitis in Children (feasibility): study protocol for a randomised controlled Trial. Trials 2018; 19: 153.
- Knaapen M, van der Lee JH, Heij HA, van Heurn ELW, Bakx R and Gorter RR. Clinical recovery in children with uncomplicated appendicitis undergoing non-operative treatment: secondary analysis of a prospective cohort study. Eur J Pediatr 2019; 178: 235-242.
- Yu G, Han A and Wang W. Comparison of Laparoscopic Appendectomy with open appendectomy in Treating Children with Appendicitis. Pak J Med Sci 2016; 32: 299-304.
- Lasek A, Pedziwiatr M, Kenig J, Waledziak M, Wysocki M, Mavrikis J, Mysliwiec P, Bobowicz M, Astapczyk K, Burdzel M, Chrusciel K, Cygan R, Czubek W, Dowgiallo-Wnukiewicz N, Dros J, Franczak P, Holowko W, Kacprzyk A, Karcz WK, Konrad P, Kopiejc A, Kot A, Krakowska K, Kukla M, Leszko A, Lozowski L, Major P, Makarewicz W, Malinowska-Torbicz P, Matyja M, Michalik M, Niekurzak A, Nowinski D, Ostaszewski R, Pabis M, Polanska-Plachta M, Rubinkiewicz M, Stefura T, Stepien A, Szabat P, Smiechowski R, Tomaszewski S, von Ehrlich-Treuenstatt V, Wasilczuk M, Wojdyla A, Wronski JW and Zwolakiewicz L. The significant impact of age on the clinical outcomes of laparoscopic appendectomy: Results from the Polish Laparoscopic Appendectomy multicenter large cohort study. Medicine (Baltimore) 2018; 97: e13621.
- Lim S, Ghosh S, Niklewski P and Roy S. Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery. JSLS 2017; 21:
- Liu Y, Cui Z and Zhang R. Laparoscopic Versus Open Appendectomy for Acute Appendicitis in Children. Indian Pediatr 2017; 54: 938-941.
- Bingener J and Ibrahim-zada I. Natural orifice transluminal endoscopic surgery for intra-abdominal emergency conditions. Br J Surg 2014; 101: e80-89.
- Chen KC, Arad A, Chen KC, Storrar J and Christy AG. The clinical value of pathology tests and imaging study in the diagnosis of acute appendicitis. Postgrad Med J 2016; 92: 611-619.
- Hornbeck PV. Enzyme-Linked Immunosorbent Assays. Curr Protoc Immunol 2015; 110: 2 1 1-2 1 23.
- Salo M, Gudjonsdottir J, Omling E, Hagander L and Stenstrom P. Association of IgE-Mediated Allergy with Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr 2018; 172: 943-948.
- Papandria D, Goldstein SD, Rhee D, Salazar JH, Arlikar J, Gorgy A, Ortega G, Zhang Y and Abdullah F. Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J Surg Res 2013; 184: 723-729.
- Talha A, El-Haddad H, Ghazal AE and Shehata G. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc 2020; 34: 907-914.
- Darwazeh G, Cunningham SC and Kowdley GC. A Systematic Review of Perforated Appendicitis and Phlegmon: Interval Appendectomy or Wait-and-See? Am Surg 2016; 82: 11-15.
- Zosimas D, Lykoudis PM, Pilavas A, Burke J, Leung P, Strano G and Shatkar V. Open versus laparoscopic appendicectomy in acute appendicitis: results of a district general hospital. S Afr J Surg 2018; 56: 59-62.
- Zwintscher NP, Johnson EK, Martin MJ and Newton CR. Laparoscopy utilization and outcomes for appendicitis in small children. J Pediatr Surg 2013; 48: 1941-1945.
- Wang D, Dong T, Shao Y, Gu T, Xu Y and Jiang Y. Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review. BMC Surg 2019; 19: 54.
- Benzel EC, Mirfakhraee M and Hadden TA. Evaluation of CSF shunt function: value of functional examination with contrast material. AJNR Am J Neuroradiol 1991; 12: 143-147.
- Chen X, Ren X, Ma Y, Ge L, Hu Z and Yan W. Research progress of the role of postoperative pain in the development of postoperative cognitive dysfunction in geriatric patients]. Nan Fang Yi Ke Da Xue Xue Bao 2019; 39: 1122-1126.
- Sarsu SB, Yilmaz SG, Bayram A, Denk A, Kargun K and Sungur MA. Polymorphisms in the IL-6 and IL-6R receptor genes as new diagnostic biomarkers of acute appendicitis: a study on two candidate genes in pediatric patients with acute appendicitis. Ital J Pediatr 2015; 41: 100.
- Khalid H, Hanif M, Hashmi MA, Mahmood T, Ayub K and Monim-Ul-Mehboob M. Copper complexes of bioactive ligands with superoxide dismutase activity. Mini Rev Med Chem 2013; 13: 1944-1956.
- Shuvaev VV, Han J, Tliba S, Arguiri E, Christofidou-Solomidou M, Ramirez SH, Dykstra H, Persidsky Y, Atochin DN, Huang PL and Muzykantov VR. Anti-inflammatory effect of targeted delivery of SOD to endothelium: mechanism, synergism with NO donors and protective effects in vitro and in vivo. PLoS One 2013; 8: e77002.
- Gawel S, Wardas M, Niedworok E and Wardas P. [Malondialdehyde (MDA) as a lipid peroxidation marker]. Wiad Lek 2004; 57: 453-455.
- Koltuksuz U, Uz E, Ozen S, Aydinc M, Karaman A and Akyol O. Plasma superoxide dismutase activity and malondialdehyde level correlate with the extent of acute appendicitis. Pediatr Surg Int 2000; 16: 559-561.
- Kumar S, Jalan A, Patowary BN and Shrestha S. Laparoscopic Appendectomy Versus Open Appendectomy for Acute Appendicitis: A Prospective Comparative Study. Kathmandu Univ Med J (KUMJ) 2016; 14: 244-248.
- Galli R, Banz V, Fenner H and Metzger J. Laparoscopic approach in perforated appendicitis: increased incidence of surgical site infection? Surg Endosc 2013; 27: 2928-2933.
- Bordbar M, Darvishzadeh R, Pazhouhandeh M, Kahrizi D. An overview of genome editing methods based on endonucleases. Modern Genetics J 2020; 15(2): 75-92.
References
Bolmers MD, van Rossem CC, Gorter RR, Bemelman WA, van Geloven AAW, Heij HA and Snapshot Appendicitis Collaborative Study g. Imaging in pediatric appendicitis is key to a low normal appendix percentage: a national audit on the outcome of appendectomy for appendicitis in children. Pediatr Surg Int 2018; 34: 543-551.
Baxter KJ, Nguyen H, Wulkan ML and Raval MV. Association of Health Care Utilization With Rates of Perforated Appendicitis in Children 18 Years or Younger. JAMA Surg 2018; 153: 544-550.
Li HM, Liu SZ, Huang YK, Su YC and Kao CH. Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study. Int J Environ Res Public Health 2018; 15:
Hutchings N, Wood W, Reading I, Walker E, Blazeby JM, Van't Hoff W, Young B, Crawley EM, Eaton S, Chorozoglou M, Sherratt FC, Beasant L, Corbett H, Stanton MP, Grist S, Dixon E and Hall NJ. CONTRACT Study - CONservative TReatment of Appendicitis in Children (feasibility): study protocol for a randomised controlled Trial. Trials 2018; 19: 153.
Knaapen M, van der Lee JH, Heij HA, van Heurn ELW, Bakx R and Gorter RR. Clinical recovery in children with uncomplicated appendicitis undergoing non-operative treatment: secondary analysis of a prospective cohort study. Eur J Pediatr 2019; 178: 235-242.
Yu G, Han A and Wang W. Comparison of Laparoscopic Appendectomy with open appendectomy in Treating Children with Appendicitis. Pak J Med Sci 2016; 32: 299-304.
Lasek A, Pedziwiatr M, Kenig J, Waledziak M, Wysocki M, Mavrikis J, Mysliwiec P, Bobowicz M, Astapczyk K, Burdzel M, Chrusciel K, Cygan R, Czubek W, Dowgiallo-Wnukiewicz N, Dros J, Franczak P, Holowko W, Kacprzyk A, Karcz WK, Konrad P, Kopiejc A, Kot A, Krakowska K, Kukla M, Leszko A, Lozowski L, Major P, Makarewicz W, Malinowska-Torbicz P, Matyja M, Michalik M, Niekurzak A, Nowinski D, Ostaszewski R, Pabis M, Polanska-Plachta M, Rubinkiewicz M, Stefura T, Stepien A, Szabat P, Smiechowski R, Tomaszewski S, von Ehrlich-Treuenstatt V, Wasilczuk M, Wojdyla A, Wronski JW and Zwolakiewicz L. The significant impact of age on the clinical outcomes of laparoscopic appendectomy: Results from the Polish Laparoscopic Appendectomy multicenter large cohort study. Medicine (Baltimore) 2018; 97: e13621.
Lim S, Ghosh S, Niklewski P and Roy S. Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery. JSLS 2017; 21:
Liu Y, Cui Z and Zhang R. Laparoscopic Versus Open Appendectomy for Acute Appendicitis in Children. Indian Pediatr 2017; 54: 938-941.
Bingener J and Ibrahim-zada I. Natural orifice transluminal endoscopic surgery for intra-abdominal emergency conditions. Br J Surg 2014; 101: e80-89.
Chen KC, Arad A, Chen KC, Storrar J and Christy AG. The clinical value of pathology tests and imaging study in the diagnosis of acute appendicitis. Postgrad Med J 2016; 92: 611-619.
Hornbeck PV. Enzyme-Linked Immunosorbent Assays. Curr Protoc Immunol 2015; 110: 2 1 1-2 1 23.
Salo M, Gudjonsdottir J, Omling E, Hagander L and Stenstrom P. Association of IgE-Mediated Allergy with Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr 2018; 172: 943-948.
Papandria D, Goldstein SD, Rhee D, Salazar JH, Arlikar J, Gorgy A, Ortega G, Zhang Y and Abdullah F. Risk of perforation increases with delay in recognition and surgery for acute appendicitis. J Surg Res 2013; 184: 723-729.
Talha A, El-Haddad H, Ghazal AE and Shehata G. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc 2020; 34: 907-914.
Darwazeh G, Cunningham SC and Kowdley GC. A Systematic Review of Perforated Appendicitis and Phlegmon: Interval Appendectomy or Wait-and-See? Am Surg 2016; 82: 11-15.
Zosimas D, Lykoudis PM, Pilavas A, Burke J, Leung P, Strano G and Shatkar V. Open versus laparoscopic appendicectomy in acute appendicitis: results of a district general hospital. S Afr J Surg 2018; 56: 59-62.
Zwintscher NP, Johnson EK, Martin MJ and Newton CR. Laparoscopy utilization and outcomes for appendicitis in small children. J Pediatr Surg 2013; 48: 1941-1945.
Wang D, Dong T, Shao Y, Gu T, Xu Y and Jiang Y. Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review. BMC Surg 2019; 19: 54.
Benzel EC, Mirfakhraee M and Hadden TA. Evaluation of CSF shunt function: value of functional examination with contrast material. AJNR Am J Neuroradiol 1991; 12: 143-147.
Chen X, Ren X, Ma Y, Ge L, Hu Z and Yan W. Research progress of the role of postoperative pain in the development of postoperative cognitive dysfunction in geriatric patients]. Nan Fang Yi Ke Da Xue Xue Bao 2019; 39: 1122-1126.
Sarsu SB, Yilmaz SG, Bayram A, Denk A, Kargun K and Sungur MA. Polymorphisms in the IL-6 and IL-6R receptor genes as new diagnostic biomarkers of acute appendicitis: a study on two candidate genes in pediatric patients with acute appendicitis. Ital J Pediatr 2015; 41: 100.
Khalid H, Hanif M, Hashmi MA, Mahmood T, Ayub K and Monim-Ul-Mehboob M. Copper complexes of bioactive ligands with superoxide dismutase activity. Mini Rev Med Chem 2013; 13: 1944-1956.
Shuvaev VV, Han J, Tliba S, Arguiri E, Christofidou-Solomidou M, Ramirez SH, Dykstra H, Persidsky Y, Atochin DN, Huang PL and Muzykantov VR. Anti-inflammatory effect of targeted delivery of SOD to endothelium: mechanism, synergism with NO donors and protective effects in vitro and in vivo. PLoS One 2013; 8: e77002.
Gawel S, Wardas M, Niedworok E and Wardas P. [Malondialdehyde (MDA) as a lipid peroxidation marker]. Wiad Lek 2004; 57: 453-455.
Koltuksuz U, Uz E, Ozen S, Aydinc M, Karaman A and Akyol O. Plasma superoxide dismutase activity and malondialdehyde level correlate with the extent of acute appendicitis. Pediatr Surg Int 2000; 16: 559-561.
Kumar S, Jalan A, Patowary BN and Shrestha S. Laparoscopic Appendectomy Versus Open Appendectomy for Acute Appendicitis: A Prospective Comparative Study. Kathmandu Univ Med J (KUMJ) 2016; 14: 244-248.
Galli R, Banz V, Fenner H and Metzger J. Laparoscopic approach in perforated appendicitis: increased incidence of surgical site infection? Surg Endosc 2013; 27: 2928-2933.
Bordbar M, Darvishzadeh R, Pazhouhandeh M, Kahrizi D. An overview of genome editing methods based on endonucleases. Modern Genetics J 2020; 15(2): 75-92.