RESUMO
BACKGROUND: The purpose of this study was to compare the postoperative inflammatory response and severity of pain between single-incision laparoscopic surgery (SILS) cholecystectomy and conventional laparoscopic cholecystectomy (LC). METHODS: Two groups of 20 patients were prospectively randomized to either conventional LC or SILS cholecystectomy. Serum interleukin-6 (IL-6) levels were assayed before surgery, at 4-6 h, and at 18-24 h after the procedure. Serum C-reactive protein (CRP) levels also were assayed at 18-24 h after surgery. Pain was measured at each of three time points after surgery using the visual analogue scale (VAS). The number of analgesia doses administered in the first 24 h after the procedure also was recorded and 30-day surgical outcomes were documented. RESULTS: The groups had equivalent body mass index (BMI), age, and comorbidity distribution. Peak IL-6 levels occurred 4-6 h after surgery, and the median level was 12.8 pg/ml in the LC and 8.9 pg/ml in the SILS group (p = 0.5). The median CRP level before discharge was 1.6 mg/dl in the LC and 1.9 mg/dl in the SILS group (p = 0.38). There was no difference in either analgesic use or pain intensity as measured by the VAS between the two groups (p = 0.72). The length of the surgical procedure was significantly longer in the SILS group (p < 0.001). No intraoperative complications occurred in either group. CONCLUSIONS: Single-incision laparoscopic surgery does not significantly reduce systemic inflammatory response, postoperative pain, or analgesic use compared with LC.
Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Inflamação/etiologia , Dor Pós-Operatória/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
A distribuiçäo das proteínas superficiais de Toxoplasma gondii radiodinadas, foram estudadas usando a técnica de separaçäo de fases e a capacidade de ligaçäo em coluna de fenil-Sepharose. Oito polipeptídeos com peso molecular entre 22 e 180.000 distribuíram-se exclusivamente na fase rica em detergente enquanto seis polipeptídeos com PM entre 15.00 e 76.000 distribuíram-se exclusivamente na fase pobre em detergente. Dois polipeptídeos com 15.00 e 70.000 distribuem-se em ambas as fases. Todos os polipeptídeos presentes na fase rica em detergente foram retidos por coluna de fenil-Sepharose e isolados em dois picos de acordo com sua hidrofobicidade relativa