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Evaluation of stress-related hormones after surgery.

INTRODUCTION
Improvements in instrumentation, optics, video cameras and technology have brought laparoscopy to the point at which many surgical procedures that once could be performed only by laparotomy are now successfully performed endoscopically.


PATIENTS AND METHOD
Twenty women undergoing surgery by laparotomy (11 patients) or laparoscopy (9 patients) were evaluated prospectively. Concentrations of adrenaline, noradrenaline, cortisol, prolactin, and ACTH were measured. Statistical analysis was performed by using the Friedman Two-way ANOVA, Kruskal-Wallis 1-way ANOVA and Mann-Whitney U-Wilcoxon Rank Sum W Test.


RESULTS
By comparing the means of all serum levels of ACTH, cortisol and prolactin between the laparoscopy and the laparotomy group, significant differences of ACTH (p < 0.0001), prolactin (p = 0.0164) and cortisol (p < 0.0001) were found. Furthermore, statistically significant differences (p < 0.05) of the serum levels of noradrenaline and adrenaline between the laparoscopy and the laparotomy group were observed.


DISCUSSION
While laparoscopic surgery causes less activation of stress-related hormones laparotomy results in a much more obvious response to all hormones evaluated, particularly catecholamine and ACTH production. This is probably related to the major tissue trauma.