***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Surgical interventions activate a cascade of reactions that result in an aseptic inflammatory reaction . This inflammatory response initiates the organism ’s innate immunity . Laparoscopic surgery reduces the trauma , and patients benefit from diminished surgical trauma and maintained immune function . Cytokine levels and C-reactive protein ( CRP ) are related to the magnitude of surgical trauma and surgical stress . Toll-like receptors ( TLRs ) 2 and 4 are the first sensor-recognition receptors of the invading pathogens for the innate immune response . This study aim ed to compare the inflammatory response and then the stress response during laparoscopic and open colectomy for cancer by calculating TLR-2 and TLR-4 as the first sensor-recognition receptors together with interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) , and high-sensitivity CRP ( hsCRP ) . Methods A total 40 patients with colorectal cancer were r and omized in two groups : group A ( open colectomy , n = 20 ) and group B ( laparoscopic colectomy , n = 20 ) .  An epidural catheter was placed in all patients 1 h preoperatively . Rupivocaine was administered perioperatively and 48 h postoperatively . Blood sample s were taken for calculation of IL-6 , TNF-α , hsCRP , TLR-2 , and TLR-4 preoperatively and 5 min after deflation of pneumoperitoneum ( group B ) or 5 min after division of the colon ( group A ) , then 6 and 24 h postoperatively . Results The mean operative time was 115 for group A and 142 min for group B. The mean blood loss was respectively 240 and 105 ml ( P < 0.001 ) , and the mean hospital stay was respectively 8 and 5 days ( P < 0.05 ) . The IL-6 level was significant higher in group A than in group B at 6 and 24 h postoperatively ( P < 0.0001 ) , and the hsCRP level was significant higher in group A than in group B at 24 h postoperatively ( P < 0.001 ) . The TNF-α values did not differ between the two groups . The TLR-2 level was significantly higher in group A than in group B at 5 min ( P = 0.013 ) and 24 h ( P = 0.007 ) postoperatively . The TLR-4 level was significant higher in group A than in group B at 5 min postoperatively ( P = 0.03 ) . Conclusion The inflammatory response and the result ant stress response are significantly less during laparoscopic colectomy than during open colectomy for colorectal cancer . This is an obvious short-term clinical benefit for the patient , providing tinder for further study to investigate the long-term results of laparoscopic colectomy versus open colectomy for colorectal cancer ( Registered clinical trial no. NCT00942461 ; www . clinical trials.gov ) Background : To evaluate the activity and safety of everolimus and identify potential biomarkers for efficacy of everolimus in patients with advanced gastric cancer ( AGC ) , who failed both fluoropyrimidine and platinum . Methods : Fifty-four patients received everolimus ( 10 mg day−1 ) . The primary objective was to determine the 4-month progression-free survival ( PFS ) rate , assumed to be 30 % . We additionally investigated the potential biomarkers for everolimus as an exploratory endpoint in those who underwent tumour biopsies . Results : Two patients ( 3.7 % ) achieved partial response and the disease control rate ( DCR ) was 38.9 % . At a median follow-up duration of 8.7 months , the 4-month PFS rate was 18.4 % , not fulfilling the primary hypothesis , with a median PFS of 1.7 months and a median overall survival of 8.3 months . The high expression of pS6Ser240/4 at baseline was significantly associated with higher DCR ( P=0.043 ) and prolonged PFS ( P=0.001 ) . Grade 1/2 asthenia ( 96.3 % ) recorded as the leading toxicity and hyperglycaemia ( 20.4 % ) was the most common non-hematological grade 3/4 toxicity . Three patients experienced grade 3/4 pneumonitis . Notably , two experienced treatment-related deaths . Conclusion : Everolimus is active against a limited number of patients with AGC . pS6Ser240/4 may be a potential predictive biomarker for everolimus , which requires validation . Careful monitoring is necessary despite generally favourable toxicity profile Background Surgical procedures are related to the activation of the inflammatory reaction . This is called surgical stress . It is believed that diminished surgical trauma reduces surgical stress . The laparoscopic approach reduces trauma , but the systemic immune responses are still invariably activated . Cytokines and C-reactive protein ( CRP ) are the main markers in the study of inflammatory or stress response . α-Defensins play an important role in host defense , acting early in phagocytosis . α-Defensins , as early markers — earlier than cytokines — of the inflammatory response , have been used , together with high-sensitivity CRP ( hs-CRP ) and interleukin-6 ( IL-6 ) , to determine the inflammatory response in laparoscopic and open colectomy for cancer . Material s and methods A total of 40 patients with colorectal cancer were r and omized to two groups : group A ( n = 20 ) , open colectomy ; group B ( n = 20 ) , laparoscopic colectomy .  One hour preoperatively an epidural catheter was placed in all patients and rupivacaine was administered perioperatively and again 48 h postoperatively . Blood sample s were taken for calculating α-defensins , IL-6 , and hs-CRP levels preoperatively , 5 min after division of the colon ( group A ) , or 5 min after deflation of pneumoperitoneum ( group B ) , 6 h and 24 h postoperatively . Results The mean operative time was 115 min for group A and 142 min for group B ( p < 0.05 ) . The mean blood loss was 240 ml and 105 ml , respectively ( p < 0.001 ) . The mean hospital stay was 8 days and 5 days , respectively ( p < 0.05 ) . α-Defensin levels were statistically significantly lower in group B than in group A , 5 min and 24 h postoperatively ( p < 0.002 and p < 0.007 , respectively ) . The IL-6 levels were statistically significantly lower in group B than in group A , 6 h and 24 h postoperatively ( p < 0.0001 at both time intervals ) , whereas the levels of hs-CRP were significantly lower in group B than in group A 24 h postoperatively ( p < 0.001 ) . Conclusions The present study confirms the results of previous studies , that the inflammatory immune response and surgical stress are significantly less after laparoscopic colectomy versus open colectomy for colorectal cancer . More investigation is needed to study if surgical stress has any influence on survival of these patients Aims and objectives To compare the perioperative inflammatory response using interleukin-6 ( IL-6 ) in patients of laparoscopic-assisted vaginal hysterectomy ( LAVH ) and non-descent vaginal hysterectomy ( NDVH ) for large uteri with benign disease . Material s and methods Twenty women with benign uterine disease and failed medical management with size of uterus ranging from 300 to 1,500 g ( 12–24 weeks ) were r and omized into two equal groups for either technique of hysterectomy , LAVH and NDVH . Venous blood levels of IL-6 were measured preoperatively and 3 , 24 and 72 h after beginning of surgery . Statistical analysis was done using SPSS15 software . Results No statistically significant difference was present in demographic characteristics , operating time , and uterine weight between the two groups . No major complications were encountered . The increase in serum interleukin 6 levels from preoperative value to the value at 3 h postoperatively was found to be significantly higher in LAVH group when compared with NDVH group indicating greater tissue h and ling and trauma in LAVH group . Conclusion Non-descent vaginal hysterectomy appears to be better than laparoscopic-assisted vaginal hysterectomy for large uteri in terms of inflammatory response Purpose Laparoendoscopic single-site surgery has recently been described in children and regarded as an improved technology leading to less pain and better cosmetic outcome . Compared to the traditional three-port method , it is not known if the single-port method is less invasive . The aim of this study was thus to investigate the post-operative acute inflammatory response in order to evaluate surgical stress in the two surgical approaches in children . Methods A prospect i ve , single blinded , case-control study was carried out . Thirteen male patients who presented with unilateral varicocele were divided into two groups . Six children underwent  single-port laparoscopic procedure , while the other seven children underwent  three-port laparoscopic procedure . Pre-operative and post-operative blood sample s were taken for the measurement of tumor necrosis factor-α ( TNF-α ) and interleukin 6 ( IL-6 ) using ELISA . Demographics including the operation time , and complications were recorded . Data between the two groups were analyzed using unpaired t-test and a p value of < 0.05 was taken as statistically significant . Results The mean age of patients was 14.5 years ( range 12–19 years ) . There was no significant difference between the two groups in terms of operative time , nor there was any complication recorded . The change in serum TNF-α and IL-6 concentrations pre- and post-operatively between the single-port group and three-port group was not statistically significant . Overall , patients in the two groups showed excellent satisfaction in terms of post-operative cosmesis . ConclusionS ingle-port laparoscopic varicocelectomy is safe , effective and produces excellent cosmesis with minimal surgical stress Background / Aims : It has recently been reported that rebamipide ( OPC-12759 ) inhibits inflammatory cytokines and activation of neutrophils . The aim of the present study was to investigate the effects of preoperative administration of rebamipide on parameters of systemic inflammatory response syndrome ( SIRS ) and serum levels of inflammatory cytokines in gastric cancer patients after gastrectomy . Patients and Methods : We measured the parameters of SIRS , circulating cytokines and acute phase reactants in patients after ( i ) distal gastrectomy with D2 lymph node dissection ( group 1 , n = 10 ) ; ( ii ) distal gastrectomy with D2 lymph node dissection following administration of rebamipide ( group 2 , n = 10 ) , and ( iii ) laparoscopy-assisted distal gastrectomy ( LADG ) with D1 lymph node dissection ( group 3 , n = 10 ) . Group 2 was administered 100 mg of rebamipide 3 times/day after meals for 7 days before surgery . Results : Among the parameters of SIRS , a difference was observed in body temperature on day 3 . The mean body temperature of group 2 was significantly lower than group 1 ( p = 0.006 ) , and was similar to group 3 . In proinflammatory cytokines , a significant difference was observed in the serum levels of interleukin (IL)-6 . On day 1 the IL-6 levels of group 2 were significantly lower than those of group 1 ( p < 0.001 ) . The changes in the IL-6 level of group 2 were similar to group 3 , except in the very early postoperative phase . However , other proinflammatory cytokines , such as IL-8 and IL-10 , were not detected , and there was no difference in C-reactive protein between the 3 groups . Conclusion : Preoperative administration of rebamipide significantly decreased postoperative body temperatures and circulating IL-6 in gastric cancer patients after gastrectomy to levels similar to those of patients with LADG Background Laparoscopy-assisted distal gastrectomy ( LADG ) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy ( ODG ) . Methods This study was performed as an exploratory analysis of a phase III trial comparing LADG and ODG for stage I gastric cancer during the period between May and December of 2011 . All patients received the same perioperative care via fast-track surgery . The level of surgical stress was evaluated based on the white blood cell count and the interleukin-6 ( IL-6 ) level . The nutritional status was measured according to the total body weight , amount of lean body mass , lymphocyte count , and prealbumin level . Results Twenty-six patients were r and omized to receive ODG ( 13 patients ) or LADG ( 13 patients ) . The baseline characteristics and surgical outcomes were similar between the two groups . The median IL-6 level increased from 0.8 to 36.3 pg/dl in the ODG group and from 1.5 to 53.3 pg/dl in the LADG group . The median amount of lean body mass decreased from 48.3 to 46.8 kg in the ODG group and from 46.6 to 46.0 kg in the LADG group . There are no significant differences between two groups . Conclusions The level of surgical stress and the nutritional status were found to be similar between the ODG 
    Output:
    
Conclusion Our results provide strong evidence that LAG is associated with significantly lower serum IL-6 levels , compared to OG .
Thus , LAG carries markedly lower risk of adverse inflammatory reactions in GC patients among Asian population