Comparison of the effects of gasless procedure, CO 2 -pneumoperitoneum, and laparotomy on splenic and hepatic natural killer activity in a rat model

Takeuchi, Ikuya; Ishida, Hideyuki; Mori, Takashi; Hashimoto, D.

doi:10.1007/s00464-002-9180-4

Cited by 9 publications

(3 citation statements)

References 20 publications

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“…More recently, it has been shown that peritoneal NK cell activity, which is also thought to be crucial in tumor cell immunosurveillance, was suppressed to a greater extent in the early postoperative period after open cecectomy than after laparoscopic cecectomy out under CO 2 pneumoperitoneum in the rodent model [43]. Interestingly, in the same study, unlike the case with the CO 2 pneumoperitoneum group, no significant suppression of peritoneal NK cell activity was detected after gasless (abdominal lift) laparoscopic cecectomy, suggesting that both laparotomy‐related trauma and insult from CO 2 pneumoperitoneum can independently suppress peritoneal NK cell activity, with the former insult being the more significant [43]. Apart from affecting peritoneal cellular immunity, the laparoscopic and open surgical methods may also have direct effects on tumor cell growth and metastatic potential.…”

Section: Impact Of Pneumoperitoneum On Regional (Ie Intra‐abdominal) ...mentioning

confidence: 99%

Is Minimal Access Surgery for Cancer Associated with Immunologic Benefits?

Whelan

Lacy

et al. 2005

World j. surg.

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Minimal-access surgical techniques have been shown to be beneficial to patients in terms of shorter convalescence, reduced pain, and improved cosmesis. Although systemic immune function is better preserved following laparoscopic procedures when compared with their respective open approaches, CO2 pneumoperitoneum may significantly affect local (i.e., infra-abdominal) cellular immunity by reducing regional macrophage function. Results to date are conflicting with regard to the impact of closed and open methods on intraabdominal immunity. Impaired cellular immunity after CO2 pneumoperitoneum may have significant undesirable intra-abdominal effects on tumor surveillance after oncological surgery; however, at present, there is no clinical evidence to support this position. The VATS techniques avoid the use of CO2 insufflation, which may offer some advantages from the immune function perspective over laparoscopic procedures accomplished with CO2 pneumoperitoneum. Better preservation of early postoperative cellular immune function and attenuated disturbance in the inflammatory mediators are likely contributing factors to the clinical benefits that follow laparoscopic surgery and VATS. Larger multi-center randomized trials are needed to confirm the potential benefits of minimal-access surgery on patient survival after cancer surgery. Future research should focus on the effects of minimal-access surgery on other mediators (such as MMP-9, IGFBP-3, IL-12, IL-17, and IL-23) that may be important in tumor cell dissemination, deposition, and propagation in the early postoperative period. Furthermore, additional searches for other factors or mediators, heretofore unrecognized, should be carried out. Such studies will, we hope, increase our knowledge and understanding of the impact of surgery on immune and other physiologic functions.

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Section: Impact Of Pneumoperitoneum On Regional (Ie Intra‐abdominal) ...mentioning

confidence: 99%

Is Minimal Access Surgery for Cancer Associated with Immunologic Benefits?

Whelan

Lacy

et al. 2005

World j. surg.

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“…There is a steep learning curve to achieve advanced laparoscopic skills. But when the learning phase has been conquered, the benefits of laparoscopic surgery have been suggested with respect to decreased morbidity, decreased pain, faster recovery, shorter hospital stay and possibly reduced immunosuppression, comparing with open surgery [9-12]. …”

Section: Introductionmentioning

confidence: 99%

Short-term and medium-term clinical outcomes of laparoscopic-assisted and open surgery for colorectal cancer: a single center retrospective case-control study

et al. 2011

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BackgroundLaparoscopic procedure is a rapid developed technique in colorectal surgery. In this investigation we aim at assessing the diversities of short-term and medium-term clinical outcomes of laparoscopic-assisted versus open surgery for colorectal cancer.MethodsA total number of 519 patients with non-metastatic colorectal cancer were enrolled for this study. The patients underwent either laparoscopic-assisted surgery (LAP) (n = 254) or open surgery (OP) (n = 265). Surgical techniques, perioperative managements and clinical follow-ups were standardized. Short-term perioperative data and medium-term recurrence and survival were compared and analyzed between the two groups.ResultsThere were no differences in perioperative parameters between the two groups except in regards to a trend of faster recovery in laparoscopic procedures. There was no statistically significant difference in postoperative complications, reoperation rate, or perioperative mortality. Statistically significant differences in a faster return of gastrointestinal function and shorter hospital stay were identified in favor of laparoscopic-assisted resection. In colon and rectal cancer cases separately, the overall survival, cancer-free survival and recurrence rate were similar in two groups. There was also no tendency of significant differences in overall survival, cancer-free survival and recurrence in stage I-II and stage III patients in two cancer categories between the two groups, respectively. pT, lymph node metastasis, and clinical stage were independent predictors of overall death risk, while pT, pN, lymph node metastasis and clinical stage were found to be the independent predictors of recurrence risk in enrolled patients database.ConclusionsLaparoscopic-assisted procedure has more benefits on postoperative recovery, while has the same effects on medium-term recurrence and survival compared with open surgery in the treatment of non-metastatic colorectal cancer.

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“…Several recent studies investigated open caecum resections in rats for this purpose [6-10], some of which examined laparoscopic techniques [11-15]. However, the data available on laparoscopic caecum resection in rats is scarce; small cohorts of animals have been used and incomplete procedural descriptions have been presented by some authors [16-24].…”

Section: Introductionmentioning

confidence: 99%

Development of a standardized laparoscopic caecum resection model to simulate laparoscopic appendectomy in rats

et al. 2014

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BackgroundLaparoscopic appendectomy (LA) has become one of the most common surgical procedures to date. To improve and standardize this technique further, cost-effective and reliable animal models are needed.MethodsIn a pilot study, 30 Wistar rats underwent laparoscopic caecum resection (as rats do not have an appendix vermiformis), to optimize the instrumental and surgical parameters. A subsequent test study was performed in another 30 rats to compare three different techniques for caecum resection and bowel closure.ResultsBipolar coagulation led to an insufficiency of caecal stump closure in all operated rats (Group 1, n = 10). Endoloop ligation followed by bipolar coagulation and resection (Group 2, n = 10) or resection with a LigaSure™ device (Group 3, n = 10) resulted in sufficient caecal stump closure.ConclusionsWe developed a LA model enabling us to compare three different caecum resection techniques in rats. In conclusion, only endoloop closure followed by bipolar coagulation proved to be a secure and cost-effective surgical approach.

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Comparison of the effects of gasless procedure, CO 2 -pneumoperitoneum, and laparotomy on splenic and hepatic natural killer activity in a rat model

Abstract: These results suggest that gasless laparoscopic surgery would be a favorable approach in terms of the preservation of NK activities.

Cited by 9 publications

References 20 publications

Is Minimal Access Surgery for Cancer Associated with Immunologic Benefits?

Is Minimal Access Surgery for Cancer Associated with Immunologic Benefits?

Short-term and medium-term clinical outcomes of laparoscopic-assisted and open surgery for colorectal cancer: a single center retrospective case-control study

Development of a standardized laparoscopic caecum resection model to simulate laparoscopic appendectomy in rats

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