Immunohumoral Response During Laparoscopic and Open Living Donor Nephrectomy: An Experimental Model

Saenz, J.; Asuero, M.S.; Villafruela, J.J.; Correa, C.; Álvarez, Julio Galindo; Cuevas, B.; Páez, Álvaro; Linares, A.; Pascual, Julio; Marcén, R.; Burgos, F.J.

doi:10.1016/j.transproceed.2007.07.008

Cited by 16 publications

(8 citation statements)

References 13 publications

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“…Many researches have observed that there is a distinct immunologic advantage to laparoscopic surgery[26-29]. Our findings confirmed better preserved cellular immune responses in patients undergoing laparoscopic colorectal resections.…”

Section: Discussionsupporting

confidence: 85%

Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity

Huang

Jiang

et al. 2010

BMC Gastroenterol

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BackgroundColorectal cancer is one kind of frequent malignant tumors of the digestive tract which gets high morbidity and mortality allover the world. Despite the promising clinical results recently, less information is available regarding the perioperative immunological effects of laparoscopic surgery when compared with the open surgery. This study aimed to compare the cellular immune responses of patients who underwent laparoscopic(LCR) and open resections(OCR) for colorectal cancer.MethodsBetween Mar 2009 and Sep 2009, 35 patients with colorectal carcinoma underwent LCR by laparoscopic surgeon. These patients were compared with 33 cases underwent conventional OCR by colorectal surgeon. Clinical data about the patients were collected prospectively. Comparison of the operative details and postoperative outcomes between laparoscopic and open resection was performed. Peripheral venous blood samples from these 68 patients were taken prior to surgery as well as on postoperative days(POD) 1, 4 and 7. Cell counts of total white blood cells, neutrophils, lymphocyte subpopulations, natural killer(NK) cells as well as CRP were determined by blood counting instrument, flow cytometry and hematology analyzer.ResultsThere was no difference in the age, gender and tumor status between the two groups. The operating time was a little longer in the laparoscopic group (P > 0.05), but the blood loss was less (P = 0.039). Patients with laparoscopic resection had earlier return of bowel function and earlier resumption of diet as well as shorter median hospital stay (P < 0.001). Compared with OCR group, cell numbers of total lymphocytes, CD4+T cells and CD8+T cells were significant more in LCR group (P < 0.05) on POD 4, while there was no difference in the CD45RO+T or NK cell numbers between the two groups. Cellular immune responds were similar between the two groups on POD1 and POD7.ConclusionsLaparoscopic colorectal resection gets less surgery stress and short-term advantages compared with open resection. Cellular immune respond appears to be less affected by laparoscopic colorectal resection when compared with open resection.

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Section: Discussionsupporting

confidence: 85%

Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity

Huang

Jiang

et al. 2010

BMC Gastroenterol

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“…The benefits in short-term outcomes with laparoscopic resection has been also supported by the reports on perioperative immunologic response [32,33]. In the early post-operative period, better reserved cellular immune responses such as higher levels of total lymphocytes, CD4 T cell, and CD8 T cell in laparoscopic resection compared with open resection was observed [34].…”

Section: Short-term Outcomesmentioning

confidence: 89%

Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery

Biondi¹,

Grosso

Mistretta

et al. 2013

BMC Surg

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BackgroundIn the late '80s the successes of the laparoscopic surgery for gallbladder disease laid the foundations on the modern use of this surgical technique in a variety of diseases. In the last 20 years, laparoscopic colorectal surgery had become a popular treatment option for colorectal cancer patients.DiscussionMany studies emphasized on the benefits stating the significant advantages of the laparoscopic approach compared with the open surgery of reduced blood loss, early return of intestinal motility, lower overall morbidity, and shorter duration of hospital stay, leading to a general agreement on laparoscopic surgery as an alternative to conventional open surgery for colon cancer. The reduced hospital stay may also decrease the cost of the laparoscopic surgery for colorectal cancer, despite th higher operative spending compared with open surgery. The average reduction in total direct costs is difficult to define due to the increasing cost over time, making challenging the comparisons between studies conducted during a time range of more than 10 years. However, despite the theoretical advantages of laparoscopic surgery, it is still not considered the standard treatment for colorectal cancer patients due to technical limitations or the characteristics of the patients that may affect short and long term outcomes.ConclusionsThe laparoscopic approach to colectomy is slowly gaining acceptance for the management of colorectal pathology. Laparoscopic surgery for colon cancer demonstrates better short-term outcome, oncologic safety, and equivalent long-term outcome of open surgery. For rectal cancer, laparoscopic technique can be more complex depending on the tumor location. The advantages of minimally invasive surgery may translate better care quality for oncological patients and lead to increased cost saving through the introduction of active enhanced recovery programs which are likely cost-effective from the perspective of the hospital health-care providers.

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“…Major concerns regarding visceral organ leaks, infectious complications, and the physiologic effect of enteric contamination call for further investigation in this area. Acute-phase cytokines have been used to quantitatively compare the operative trauma of laparoscopy versus open surgery [18][19][20][21][22][23][24]. Randomized studies in colon and rectal surgery could demonstrate significantly larger increases in plasma IL-1b in patients who undergo open sigmoidectomy versus laparoscopic resection [21].…”

Section: Introductionmentioning

confidence: 99%

Inflammatory impact of NOTES peritoneoscopy is not different from that of laparoscopy: a randomized comparative study in a survival porcine model

et al. 2011

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Immunohumoral Response During Laparoscopic and Open Living Donor Nephrectomy: An Experimental Model

Cited by 16 publications

References 13 publications

Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity

Laparoscopic and open resection for colorectal cancer: an evaluation of cellular immunity

Laparoscopic vs. open approach for colorectal cancer: evolution over time of minimal invasive surgery

Inflammatory impact of NOTES peritoneoscopy is not different from that of laparoscopy: a randomized comparative study in a survival porcine model

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