Correlation of postoperative inflammatory markers and clinical outcomes with intraoperative carbon dioxide pneumoperitoneum pressure levels in laparoscopic appendectomy

Table 1 Baseline characteristics of the four study groups, n (%)/mean ± SD

Variable	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	P value
Age (years)	38.2 ± 11.5	39.1 ± 10.9	37.8 ± 12.0	38.5 ± 11.3	0.742
Sex (male)	28 (50.9)	29 (53.7)	28 (52.8)	30 (54.5)	0.821
BMI (kg/m2)	23.5 ± 2.8	23.8 ± 2.6	23.3 ± 2.9	23.6 ± 2.7	0.689
ASA I/II (n)	30/25	28/26	29/24	31/24	0.953
Disease duration (hour)	14.2 ± 5.3	13.9 ± 5.6	14.5 ± 5.1	14.0 ± 5.4	0.862
Preop WBC (× 109/L)	14.52 ± 1.24	14.78 ± 1.11	14.27 ± 1.13	14.30 ± 1.34	0.103
Preop PCT (ng/mL)	2.32 ± 0.41	2.06 ± 0.48	2.17 ± 0.51	2.19 ± 0.60	0.056

BMI: Body mass index; ASA: American Society of Anesthesiologists; WBC: White blood cell; PCT: Procalcitonin.

Table 2 Comparison of white blood cell levels before and after surgery in four patient groups, mean ± SD

Inflammatory markers	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
Preoperative WBC (109/L)	14.52 ± 1.24	14.78 ± 1.11	14.27 ± 1.13	14.30 ± 1.34	2.086	0.103
WBC on postoperative day 1 (109/L)	12.17 ± 0.87	12.73 ± 1.171	12.74 ± 1.001	12.84 ± 1.191	4.461	0.005
WBC on postoperative day 3 (109/L)	7.20 ± 1.46	7.94 ± 1.181	7.97 ± 1.281	8.03 ± 1.311	4.818	0.003

¹Compared with group A at the same time point, P < 0.01 (after Bonferroni correction).

WBC: White blood cell.

Table 3 Comparison of inflammatory marker procalcitonin levels among patients in groups A, B, C, and D, mean ± SD

Inflammatory markers	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
Preoperative PCT (ng/mL)	2.32 ± 0.41	2.06 ± 0.48	2.17 ± 0.51	2.19 ± 0.60	2.557	0.056
Postoperative day 1 PCT (ng/mL)	1.60 ± 0.57	1.93 ± 0.601	1.97 ± 0.781	1.98 ± 0.681	4.188	0.007
Postoperative day 3 PCT (ng/mL)	0.34 ± 0.14	0.42 ± 0.131	0.42 ± 0.151	0.45 ± 0.131	6.462	< 0.001

¹Compared with group A at the same time point, P < 0.01 (after Bonferroni correction).

PCT: Procalcitonin.

Table 4 Comparison of surgical-related indicators among patients in groups A, B, C, and D, n (%)/mean ± SD

Surgical-related indicators	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
Operating time (minute)	40.80 ± 8.05	42.61 ± 6.98	40.45 ± 6.98	40.33 ± 6.43	1.196	0.312
Intraoperative blood loss (mL)	15.27 ± 5.11	15.8 ± 4.92	14.9 ± 5.34	16.1 ± 5.68	0.478	0.698
Conversion to open surgery	0 (0)	0 (0)	1 (1.9)	0 (0)	-	0.2551

¹Fisher’s exact probability method.

Table 5 Comparison of numerical pain rating scale pain scores among patients in groups A, B, C, and D, mean ± SD

NRS pain score	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
Preoperative (score)	6.09 ± 1.36	6.44 ± 1.33	6.19 ± 1.27	6.04 ± 1.51	0.942	0.421
Day 1 postoperatively (score)	3.89 ± 1.29	4.48 ± 1.181	4.66 ± 1.191	4.78 ± 1.521	5.029	0.002
Day 3 postoperatively (score)	1.80 ± 0.59	2.11 ± 0.661	2.15 ± 0.691	2.18 ± 0.701	3.899	0.010

¹Compared with group A at the same time point, P < 0.01 (after Bonferroni correction).

NRS: Numerical pain rating scale.

Table 6 Comparison of basic activities of daily living scores among four patient groups, mean ± SD

BADL scale score	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
Preoperative (score)	75.18 ± 3.84	74.26 ± 3.69	75.00 ± 3.54	75.45 ± 3.51	1.070	0.363
Day 1 postoperatively (score)	60.91 ± 3.61	56.39 ± 4.491	53.30 ± 4.151	49.55 ± 3.761	78.793	< 0.001
Day 3 postoperatively (score)	80.27 ± 4.13	77.78 ± 4.731	74.91 ± 4.651	71.45 ± 4.881	37.324	< 0.001

¹Compared with group A at the same time point, P < 0.01 (after Bonferroni correction).

BADL: Basic activities of daily living.

Table 7 Comparison of postoperative recovery and complications among the four patient groups, n (%)/mean ± SD

Postoperative recovery status	Group A (n = 55)	Group B (n = 54)	Group C (n = 53)	Group D (n = 55)	F value	P value
First postoperative ambulation, duration(hour)	9.15 ± 0.69	9.48 ± 0.621	9.53 ± 0.771	9.57 ± 0.711	4.070	0.008
First postoperative anal defecation, time of gas administration (hour)	15.73 ± 1.15	16.52 ± 1.432	16.57 ± 1.362	16.73 ± 1.482	5.894	0.001
Postoperative hospitalization days (day)	4.47 ± 0.57	4.76 ± 0.551	4.79 ± 0.531	4.82 ± 0.641	4.263	0.006
Complications	2 (3.6)	2 (3.7)	3 (5.7)	3 (5.5)	χ2 = 0.457	0.928

¹Compared with group A, P < 0.05 (after Bonferroni correction).

²Compared with group A, P < 0.01 (after Bonferroni correction).