Effect of Prednisolone on Local and Systemic Response in Laparoscopic vs. Open Colon Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial

PURPOSE: This study was designed to assess whether preoperative, short-term, intravenously administered high doses of methylprednisolone (30 mg/kg 90 minutes before surgery) influence local and systemic biohumoral responses in patients undergoing laparoscopic or open resection of colon cancer. METHODS: Fifty-two patients who were candidates for curative colon resection were randomly assigned to laparoscopic or open surgery and, in a double-blind design, assigned to receive methylprednisolone (n = 26) or placebo (n = 26). Pulmonary function, postoperative pain, C-reactive protein, interleukins 6 and 8, and tumor necrosis factor alpha were analyzed, as was patient outcome. RESULTS: The steroid and placebo groups were well balanced for preoperative variables, as were the subgroups of patients who underwent laparoscopic (methylprednisolone, n = 13; placebo, n = 13) and open surgery (methylprednisolone, n = 13; placebo, n = 13). No adverse events related to steroid administration occurred. In the methylprednisolone groups, significant improvement in pulmonary performance (P = 0.01), pain control (P = 0.001), and length of stay (P = 0.03) were observed independent of the surgical technique. No differences in morbidity or anastomotic leak rate were observed among groups. CONCLUSION: Preoperative administration of methylprednisolone in colon cancer patients may improve pulmonary performance and postoperative pain, and shorten length of stay regardless of the surgical technique used (laparoscopy, open colon resection).