Effect of laparoscopy on immune function

Gupta, Arobinda; Watson, David I.

doi:10.1046/j.0007-1323.2001.01860.x

Cited by 150 publications

(98 citation statements)

References 98 publications

(91 reference statements)

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“…Laparoscopic surgery has been shown to provide important advantages on the short term when compared to open surgery for the treatment of several malignant diseases with at least the same long term survival (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis

Martínez-Ramos

Miralles-Tena

Cuesta

et al. 2011

Rev. esp. enferm. dig.

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Background:there are few studies in the literature comparing laparoscopic versus open Gastrectomy, predominantly for advanced gastric cancer (AGC). Most of the available studies and meta-analysis compare both approaches in the early gastric cancer. The meta-analysis, here presented, compares the clinical outcomes between these two procedures for AGC.Objectives: to evaluate the current status of both partial and total laparoscopic gastrectomy (LG), with regard to its short and long-term outcomes by comparing it to conventional open gastrectomy (OG) for AGC.Data sources and review methods: original articles published in English language from January 1991 to October 2009 were searched in the Medline, Embase, Current Contents, Science Citation Index databases and Cochrane Controlled Trials Register. All articles comparing LG and OG for AGC were included, and those comparing outcomes only for early gastric cancer (EGC) were excluded. Clinical appraisal and data extraction were conducted independently by 3 reviewers. Statistical analysis was carried out following the DerSimonian-Laird random effects model.Results: out of 2,344 studies, 7 studies were selected. One prospective randomized controlled trial, one comparative prospective study and five comparative retrospective studies were analyzed. These studies include a total of 452 patients with gastric cancer, 174 patients in the LG and 278 in the OG. The analyzed result variables were operative time, operative blood loss, hospital postoperative stay, number of dissected lymph nodes and cancerrelated mortality risk. Compared to OG, LG was a longer procedure: weighted mean difference (WMD) 44 minutes; 95% confidence interval (CI) 20 to 69; I-squared = 91.6%, but was associated with a lower blood loss (WMD -122 cc; 95% CI -208 to -37; I-squared = 90.8%); this was more significant for hospital operative stay (WMD -6.2 days; 95% CI -9.4 to -2.8; I-squared = 67.8%). Moreover there were no significant differences between the two groups concerning the number of dissected lymph nodes (WMD -1.57; 95% CI -3.41 to 0.26; I-squared = 8.3) and no significant differences for cancer-related mortality risk (adjusted for 60 months of follow-up) although there was a tendency toward a protective effect for LG (Odds Ratio 0.53; 95% CI 0.23 to 1.22; Isquared 41%).Conclusion: laparoscopic total and partial gastrectomy for AGC is associated with a longer operative time but lower blood loss and shorter postoperative hospital stay. Moreover there were similar outcomes between both approaches in terms of number of dissected lymph nodes and long-term follow-up (survival).Key words: Advanced gastric cancer surgery. Laparoscopic gastrectomy. Open gastrectomy. Meta-analysis. INTRODUCTIONLaparoscopic surgery has been shown to provide important advantages on the short term when compared to open surgery for the treatment of several malignant diseases with at least the same long term survival (1-6).However, while laparoscopic surgery has been accepted worldwide for selected GIST tumors, early gastric c...

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Section: Introductionmentioning

confidence: 99%

Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis

Martínez-Ramos

Miralles-Tena

Cuesta

et al. 2011

Rev. esp. enferm. dig.

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“…Therefore, IL-6 levels don't increase greatly in the picture of acute appendicitis as result of infection in the gastrointestinal system but do increase in cases where tissue damage occurs due to surgical intervention. [3][4][5] In a study that supports this conclusion, Yildirim et al [1] investigated leukocyte count, IL-6, and C-reactive protein (CRP) levels in patients with prediagnosis of acute appendicitis. They stated that leukocyte count and CRP levels may be helpful in diagnosis of acute appendicitis.…”

Section: Discussionmentioning

confidence: 74%

Evaluation of the open and laparoscopic appendectomy operations with respect to their effect on serum IL-6 levels

Bartın

Kemik

Çaparlar

et al. 2016

Ulus Travma Acil Cerrahi Derg

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“…Particularly in patients with cancer, better preserved postoperative immunity may result in more favorable long-term oncological results. It was previously reported that the systemic immune response was better preserved after laparoscopic surgery as compared to after conventional surgery (21)(22). The acute-phase response is a favorable indicator of tissue injury in patients (23).…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of surgical stress of laparoscopically assisted vaginal radical hysterectomy and lymphadenectomy and laparotomy for early-stage cervical cancer

Hou

Jiang

et al. 2011

Oncology Letters

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Abstract. The aim of this study was to objectively evaluate the benefits of laparoscopically assisted vaginal radical hysterectomy and lymphadenectomy for early-stage cervical cancer. Clinical data were prospectively collected from patients with IA-IIB cervical cancer who underwent laparoscopically assisted vaginal radical hysterectomy (n1=33) and laparotomy (n2=30). Peripheral blood samples were obtained prior to surgery and at 1 and 2 h into the operation, as well as on days 1, 4 and 7 following surgery to measure serum interleukin-6, C-reaction protein and cortisol. Results showed that there was no conversion to laparotomy in the laparoscopy group. The average blood loss was 317.23±217.20 ml (laparoscopy group) and 872.58±693.16 ml (laparotomy group). No significant difference was found in the number of resected pelvic lymph nodes (19.74±7.43 in the laparoscopy group and 20.35±6.62 in the laparotomy group). At days 1 and 7 after surgery, the serum IL-6 level was significantly different in the laparoscopy and laparotomy groups (day 1: laparoscopy group 17.14±16.53 pg/ml and laparotomy group 34.32±20.97 pg/ml, p= 0.001; day 7: laparoscopy group 6.7±7.21 pg/ml and laparotomy group 17.54±16.47 pg/ml, p=0.001). The serum CRP level was significantly different at days 1 and 7 after the operation (day 1: laparoscopy group 7024.72±949.12 ng/ml and laparotomy group 7586.61±869.42 ng/ml, p=0.018; day 7: laparoscopy group 4357.71±2108.85 ng/ml and laparotomy group 6967.96±995.02 ng/ml, p<0.001). A significant difference was noted in the serum cortisol level at day 4 after the operation (122.29±65.17 ng/ml in the laparoscopy group and 186.76±68.61 ng/ml in the laparotomy group, p<0.001). In conclusion, the differences in clinical data and the various parameters pertinent to surgical stress evaluated in this study suggest that laparoscopic surgery for cervical cancer causes less postoperative stress than conventional open surgery.

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Effect of laparoscopy on immune function

Cited by 150 publications

References 98 publications

Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis

Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis

Evaluation of the open and laparoscopic appendectomy operations with respect to their effect on serum IL-6 levels

Comparative evaluation of surgical stress of laparoscopically assisted vaginal radical hysterectomy and lymphadenectomy and laparotomy for early-stage cervical cancer

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