Laparoscopic versus conventional Nissen fundoplication: the influence on plasma insulin-like growth factor-I and insulin-like growth factor binding protein-3.

BACKGROUND Conventional surgery is known to influence postoperative insulin-like growth factor-I (IGF-I) levels and to increase protein breakdown. Recent animal data described that laparoscopic surgery, in contrast to conventional surgery, maintains postoperative IGF-I levels, suggesting a reduced postoperative catabolic response. AIM The aim of this study was to demonstrate differences in the postoperative catabolic response between laparoscopic and conventional surgery. METHODS Seventeen patients scheduled for Nissen fundoplication were randomly assigned to undergo either a laparoscopic or a conventional procedure. The catabolic response was assessed by measuring total IGF-I and insulin-like growth factor binding protein-3 (IGFBP-3). RESULTS IGF-I levels decreased significantly 4 days after both types of surgery. IGFBP-3 decreased more rapidly after conventional surgery than after the laparoscopic technique; however, the differences between the groups were not significant. CONCLUSION In contrast to animal data, no differences in plasma IGF-I or IGFBP-3 were seen in patients undergoing laparoscopic or conventional Nissen fundoplication.