Effect of Laparoscopy on the Immune System

Surgery induces alterations in local and systemic immune responses. These changes appear to be associated with an increase in postoperative morbidity. Minimally invasive techniques are considered to improve the preservation of immune function compared with open surgery and may therefore be beneficial for patient recovery. As laparoscopic techniques are increasingly used in abdominal surgery, more research has focussed on the immunologic consequences of these techniques. Nevertheless, the changes that occur in response to trauma are still not completely understood. The immunologic benefits of laparoscopic surgery are the most obvious for minor surgical procedures such as cholecystectomy and antireflux surgery. For more complex procedures such as colorectal surgery for cancer, the benefits are not immediately obvious. Although laparoscopic surgery for colorectal malignancies may be associated with higher survival rates and lower recurrence rates because of improved immune function, it has also been related to high incidences of port-site metastases. Reviews in the literature have now shown that incidences of port-site metastases are comparable to incidences of wound metastases after open surgery. However, it will be necessary to wait for the long-term results of randomized, clinical trials to provide further clarification of how immune function is altered after laparoscopic and open surgery for colorectal cancer.

[1]  M. Treat,et al.  Postoperative cell mediated immune response is better preserved after laparoscopic vs open colorectal resection in humans , 2003, Surgical Endoscopy And Other Interventional Techniques.

[2]  Mario Morino,et al.  Laparoscopic Total Mesorectal Excision: A Consecutive Series of 100 Patients , 2003, Annals of surgery.

[3]  M. Kitajima,et al.  Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer , 2003, Surgical Endoscopy And Other Interventional Techniques.

[4]  M. Cuesta,et al.  Systemic and Peritoneal Inflammatory Response After Laparoscopic or Conventional Colon Resection in Cancer Patients , 2003, Diseases of the colon and rectum.

[5]  C. Jacobi,et al.  Immunologic Changes during Minimally Invasive Surgery , 2002, Digestive Surgery.

[6]  Marco Braga,et al.  Laparoscopic Versus Open Colorectal Surgery: A Randomized Trial on Short-Term Outcome , 2002, Annals of surgery.

[7]  Antoni Castells,et al.  Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial , 2002, The Lancet.

[8]  F. Spertini,et al.  Reduced acute phase response after laparoscopic total extraperitoneal bilateral hernia repair compared to open repair with the Stoppa procedure , 2002, Surgical Endoscopy And Other Interventional Techniques.

[9]  C. Nduka,et al.  Intraperitoneal hypothermia during surgery enhances postoperative tumor growth , 2002, Surgical Endoscopy.

[10]  J. Hurteau,et al.  Effect of carbon dioxide on human ovarian carcinoma cell growth. , 2001, American journal of obstetrics and gynecology.

[11]  W. J. Russell,et al.  Metabolic and immunologic consequences of laparoscopy with helium or carbon dioxide insufflation: A randomized clinical study , 2001, ANZ journal of surgery.

[12]  M. Schietroma,et al.  Evaluation of immune response in patients after open or laparoscopic cholecystectomy. , 2001, Hepato-gastroenterology.

[13]  W. Schwenk,et al.  Cellular and humoral inflammatory response after laparoscopic and conventional colorectal resections , 2001, Surgical Endoscopy.

[14]  J. Tellado,et al.  Defense mechanisms of the peritoneal cavity , 2001, Current opinion in critical care.

[15]  K. Karadayi,et al.  Comparison of postoperative acute-phase reactants in patients who underwent laparoscopic v open cholecystectomy: a randomized study. , 2000, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[16]  J. Marescaux,et al.  Dual Effect of Laparoscopy on Cell-Mediated Immunity , 2000, European Surgical Research.

[17]  S. Evans,et al.  Intraperitoneal macrophages and tumor immunity: A review , 2000, Journal of surgical oncology.

[18]  E. Steyerberg,et al.  Intraperitoneal tumor growth is influenced by pressure of carbon dioxide pneumoperitoneum , 2000, Surgical Endoscopy.

[19]  G. Di Vita,et al.  [Cell-mediated immunity after laparoscopic cholecystectomy]. , 2000, Annali italiani di chirurgia.

[20]  W. Meng,et al.  Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: A prospective randomized trial. , 2000, Annals of surgery.

[21]  C. Herfarth,et al.  Effect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy , 2000, Surgical Endoscopy.

[22]  S. Heys,et al.  Minimal access surgery for cholelithiasis induces an attenuated acute phase response. , 1999, American journal of surgery.

[23]  C. Boselli,et al.  [Perioperative changes in the plasma levels of fibrinogen and D-dimer during laparoscopic cholecystectomy: the preliminary results of a prospective randomized clinical study]. , 1999, Annali italiani di chirurgia.

[24]  M. Cuesta,et al.  A prospective randomized study of the systemic immune response after laparoscopic and conventional Nissen fundoplication. , 1999, Surgery.

[25]  A. Darzi,et al.  Comparison of immunologic and physiologic effects of CO2 pneumoperitoneum at room and body temperatures , 1999, Surgical Endoscopy.

[26]  C. Sietses,et al.  Immunological consequences of laparoscopic surgery, speculations on the cause and clinical implications , 1999, Langenbeck's Archives of Surgery.

[27]  K. Horvath,et al.  Increased tumor establishment and growth after open vs laparoscopic surgery in mice may be related to differences in postoperative T-cell function , 1999, Surgical Endoscopy.

[28]  G. Hasçelik,et al.  Effects of laparotomy, and carbon dioxide and air pneumoperitoneum, on cellular immunity and peritoneal host defences in rats. , 1999, The European journal of surgery = Acta chirurgica.

[29]  A. Katila,et al.  Immune response after laparoscopic and conventional Nissen fundoplication. , 1999, The European journal of surgery = Acta chirurgica.

[30]  A. Lacy,et al.  Port site metastases and recurrence after laparoscopic colectomy , 1998, Surgical Endoscopy.

[31]  S. Kwok,et al.  Laparoscopic-assistedvs. open surgery for colorectal cancer , 1998, Diseases of the colon and rectum.

[32]  A. Rofe,et al.  The effect of laparoscopy on the movement of tumor cells and metastasis to surgical wounds , 1997, Surgical Endoscopy.

[33]  I. Sayek,et al.  Laparoscopic surgery is associated with less tumour growth stimulation than conventional surgery: An experimental study , 1997, The British journal of surgery.

[34]  J. Rodriguez,et al.  Mechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery. , 1997, Annals of surgery.

[35]  M. Treat,et al.  Postoperative immune function varies inversely with the degree of surgical trauma in a murine model , 1997, Surgical Endoscopy.

[36]  A. Karayiannakis,et al.  Systemic stress response after laparoscopic or open cholecystectomy: A randomized trial , 1997, The British journal of surgery.

[37]  G. Ramadori,et al.  Cytokines and the hepatic acute phase response , 1997, The Journal of pathology.

[38]  R. Beart,et al.  Wound recurrence following laparoscopic colon cancer resection , 1996, Diseases of the colon and rectum.

[39]  D. Rosenthal,et al.  Prospective comparison of openvs. laparoscopic colon surgery for carcinoma , 1996, Diseases of the colon and rectum.

[40]  P. Hewett,et al.  Intraperitoneal cell movement during abdominal carbon dioxide insufflation and laparoscopy , 1996, Diseases of the colon and rectum.

[41]  R. Allardyce,et al.  Tumor cell distribution following laparoscopic colectomy in a porcine model , 1996, Diseases of the colon and rectum.

[42]  J. Hall,et al.  Peritoneal defences and peritoneum‐associated lymphoid tissue , 1996, The British journal of surgery.

[43]  S. Kwok,et al.  Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. , 1996, Annals of surgery.

[44]  H. Nelson,et al.  Wound recurrence following conventional treatment of colorectal cancer , 1996, Diseases of the colon and rectum.

[45]  N. Taffinder,et al.  Port site metastases after laparoscopic colorectal surgery for cure of malignancy , 1996, The British journal of surgery.

[46]  H. Redmond,et al.  Exposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model , 1995, The British journal of surgery.

[47]  E. Kobayashi,et al.  Laparoscopic cholecystectomy minimally impairs postoperative cardiorespiratory and muscle performance , 1995, The British journal of surgery.

[48]  R. Beart,et al.  Role of laparoscopy in colorectal surgery A prospective evaluation of 200 cases , 1995, Diseases of the colon and rectum.

[49]  O. Garden,et al.  Abdominal wall metastases following laparoscopy , 1995, The British journal of surgery.

[50]  N. Bordone,et al.  Effects of surgical trauma of laparoscopic vs. open cholecystectomy. , 1994, Hepato-gastroenterology.

[51]  J. Rastad,et al.  Laparoscopic versus open cholecystectomy: Hospitalization, sick leave, analgesia and trauma responses , 1994, The British journal of surgery.

[52]  M. Treat,et al.  Is immune function better preserved after laparoscopic versus open colon resection? , 1994, Surgical Endoscopy.

[53]  G. Kazemier,et al.  Subcutaneous metastases after laparoscopic colectomy , 1994, The Lancet.

[54]  Randall W. Smith,et al.  A Prospective Randomized Trial Comparing Open Versus Laparoscopic Appendectomy , 1994, Annals of surgery.

[55]  J. Earnshaw,et al.  Laparoscopic surgery for colorectal cancer , 1994, The British journal of surgery.

[56]  N. Blumberg,et al.  Blood transfusions and prognosis in colorectal cancer. , 1993, The New England journal of medicine.

[57]  A. Cuschieri,et al.  Outcome after cholecystectomy for symptomatic gall stone disease and effect of surgical access: laparoscopic v open approach. , 1993, Gut.

[58]  T. Wilson,et al.  Subcutaneous metastases after laparoscopic resection of malignancy. , 1993, The Australian and New Zealand journal of surgery.

[59]  O. Reiertsen,et al.  Laparoscopic and open cholecystectomy. A prospective, randomized study. , 1993, The European journal of surgery = Acta chirurgica.

[60]  J. Monson,et al.  Changes in major histocompatibility complex class II expression in monocytes and T cells of patients developing infection after surgery , 1993, The British journal of surgery.

[61]  B. Jaques,et al.  Laparoscopically assisted colectomy and wound recurrence , 1993, The Lancet.

[62]  D. Kwiatkowski,et al.  Systemic cytokine response after major surgery , 1992, The British journal of surgery.

[63]  A. Ogata,et al.  Interleukin-6 as a new indicator of inflammatory status: detection of serum levels of interleukin-6 and C-reactive protein after surgery. , 1992, Surgery.

[64]  H. Polk,et al.  HLA-DR antigen expression on peripheral blood monocytes correlates with surgical infection. , 1991, American journal of surgery.

[65]  W. Fraser,et al.  Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. , 1990, Clinical science.

[66]  D. A. Cook,et al.  Hormonal Responses to Graded Surgical Stress , 1988 .

[67]  B. Shenton,et al.  The influence of surgical operations on components of the human immune system , 1985, The British journal of surgery.

[68]  A. Polglase,et al.  Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery , 1983, Diseases of the colon and rectum.

[69]  J. Welch,et al.  Detection and treatment of recurrent cancer of the colon and rectum. , 1978, American journal of surgery.

[70]  L. Gunderson,et al.  Areas of failure found at reoperation (second or symptomatic look) following “curative surgery” for adenocarcinoma of the rectum: Clinicopathologic correlation and implications for adjuvant therapy , 1974, Cancer.

[71]  T. K. Hunt,et al.  Sequential changes in the cell mediators of peritoneal and wound fluids after surgery , 2004, Surgery Today.

[72]  O. Rotstein.  Peritoneal host defenses: modulation by carbon dioxide insufflation. , 2001, Surgical infections.

[73]  W. Schwenk,et al.  Inflammatory response after laparoscopic and conventional colorectal resections – results of a prospective randomized trial , 2000, Langenbeck's Archives of Surgery.

[74]  G. Kazemier,et al.  Port-site metastases. Impact of local tissue trauma and gas leakage. , 1998, Surgical endoscopy.

[75]  J. Müller,et al.  [Effect of intra-abdominal pressure in laparoscopy on intraperitoneal tumor growth and development of trocar metastases. An animal experiment study in the rat model]. , 1998, Langenbecks Archiv fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft fur Chirurgie. Kongress.

[76]  S. Papagrigoriadis.  Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma. , 1997, The British journal of surgery.

[77]  H. Bonjer,et al.  Impact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases. , 1996, Annals of surgery.

[78]  J. Hamming,et al.  Laparoscopic surgery in the rat. Beneficial effect on body weight and tumor take. , 1996, Surgical endoscopy.

[79]  A Jansen,et al.  Laparoscopic-assisted colon resection. Evolution from an experimental technique to a standardized surgical procedure. , 1994, Annales chirurgiae et gynaecologiae.

[80]  A. Darzi,et al.  Experience with laparoscopic colorectal surgery for malignant disease. , 1993, Surgical oncology.

[81]  E. Phillips,et al.  Laparoscopic colectomy. , 1992, Annals of surgery.

[82]  D. Dunn,et al.  Macrophages and translymphatic absorption represent the first line of host defense of the peritoneal cavity. , 1987, Archives of surgery.