Analysis of the Immune Response of a Laparoscopic Surgery between Gas and Gasless Techniques.
- Author:
Won Woo KIM
1
;
Jong Eun LEE
;
Hea Myung JEON
;
Eung Kook KIM
Author Information
1. Department of Surgery, Catholic University Medical College.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Immunologic effect;
Gas laparoscopic procedure;
Gasless laparoscopic procedure
- MeSH:
Allergy and Immunology;
Bacteriophages;
Cholecystectomy;
Cytokines;
Humans;
Hydrocortisone;
Interleukin-6;
Interleukin-8;
Laparoscopy*;
Leukocyte Count;
Macrophages, Peritoneal;
Postoperative Period;
Tumor Necrosis Factor-alpha
- From:Journal of the Korean Surgical Society
2000;58(5):684-693
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the immunologic effect of the gasless laparoscopic procedure, we compared it with an immunologically effective, gas insuffulated (pneumoperitoneal) laparoscopic procedure. METHODS: The temporal immune responses in two similar groups of patients randomized to gas vs gasless laparo scopic cholecystectomy were analyzed. The patients were matched by age, weight, and operation time. Immune parameters, including serum white blood cell count and TNF-alpha, INF-gamma, IL-6, IL-8, cortisol and ESR levels, were assessed preoperatively and on postoperative days 1 and 3 between the two groups. Also during the operations, cytokines were checked in cultured peritoneal macrophages. RESULTS: The results were as follows: 1) Serum cortisol and ESR levels were not statistically different between the two groups. White blood cell counts were also not statistically different. 2) The preoperative and postoperative day 1 and days 3 serum TNF-alpha, INF-gamma, IL-6, and IL-8 levels in the two group were not statistically different. However, an immediate decrease cytokine levels was significant in both groups after postoperative day 1. 3) Especially cytokine levels were more increased in cultured peritoneal macro phages than in serum, but difference between the two groups was not statistically significant. CONCLUSION: From our results the beneficial effects of immunology in a gasless laparoscopic procedure were not different from those in a gas laparoscopic procedure. Rather, immediate preservation of the immune function during the postoperative period was detected in both groups.
