Impact of surgery on immunologic function: comparison between minimally invasive techniques and conventional laparotomy for surgical resection of colorectal tumors.

Abstract

BACKGROUND:

Surgical trauma suppresses host immune function, potentially creating an environment vulnerable to tumor cell growth. This study compared immune function after laparoscopy, minilaparotomy, and conventional colorectal tumor resections.

METHODS:

Seventy-one patients underwent surgery (20 laparoscopy, 21 minilaparotomy, and 30 conventional). Blood samples were taken before surgery and at 3 hours, 24 hours, and 5 days after surgery. White blood cell constitution was determined using monoclonal antibodies. Levels of TH1 cytokines interferon-gamma, tumor necrosis factor-alpha, and interleukin (IL)-2 and TH2 cytokines IL-10, -4, and -6 were measured in plasma and from supernatants of activated peripheral blood mononuclear cells.

RESULTS:

At 5 days after surgery, lymphocyte counts remained low in the conventional and minilaparotomy groups (P = .001 and P = .008) but had resolved in laparoscopic patients. Three-hour postoperative serum IL-6 concentrations were lower in laparoscopic than in conventional patients (P = .028). Production of TH1 cytokines 3 hours after surgery were significantly increased in laparoscopic patients (interferon-gamma P = .018, tumor necrosis factor-alpha P = .011, and IL-2 P = .037).

CONCLUSIONS:

TH1 lymphocyte function is improved transiently and immune homeostasis restored earlier in patients undergoing laparoscopic colorectal cancer resection, which may influence disease recurrence.

• Authors: Charles Evans, Christine Galustian, Devinder Kumar, Robert Hagger, David M Melville, Mark Bodman-Smith, Ian Jourdan, Andrew M Gudgeon, Angus G Dalgleish
• Journal: American journal of surgery (Am J Surg) Vol. 197 Issue 2 Pg. 238-45 (Feb 2009) ISSN: 1879-1883 [Electronic] United States
• PMID: 18639228 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Colorectal Neoplasms (surgery)
• Female
• Humans
• Immune System Diseases (etiology, immunology)
• Laparotomy (adverse effects)
• Male
• Minimally Invasive Surgical Procedures (adverse effects)
• Th1 Cells (immunology)