Immunological Effects of Laparoscopic vs Open Colorectal Surgery

Wichmann, Matthias W.; Hüttl, T. P.; Winter, Hauke; Spelsberg, F; Angele, Martin K.; Heiss, M. M.; Jauch, Karl‐Walter

doi:10.1001/archsurg.140.7.692

Cited by 159 publications

(110 citation statements)

References 39 publications

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“…Lacy and colleagues suggest that effector cells of nonspecific immune response, that is, natural-killer cells, which are thought to be crucial in tumor cell immunosurveillance, are suppressed to a greater extent in the early postoperative period following open colectomy compared with laparoscopy assisted colectomy [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes after laparoscopic colectomy

Braga¹,

Pecorelli²,

Frasson³

et al. 2011

WJGO

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AIM:To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection. METHODS: From February 2000 to December 2004, six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic (LPS, n = 330) or open (n = 332) colorectal resection. All patients were analyzed on an intention-to-treat basis. Long-term follow-up was carried out every 6 mo by office visits. In 526 cancer patients five-year overall and disease-free survival were evaluated. Median oncologic follow-up was 96 mo. RESULTS:Eight (4.2%) LPS group patients needed conversion to open surgery. Overall long-term morbidity rate was 7.6% (25/330) in the LPS vs 11.1% (37/332) in the open group (P = 0.17). In cancer patients, fiveyear overall survival was 68.6% in the LPS group and 64.0% in the Open group (P = 0.27). Excluding stage Ⅳ patients, five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group (P = 0.36). Further, no difference in recurrence rate was found when patients were stratified according to cancer stage. CONCLUSION:LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery. No difference between groups was found in overall and disease-free survival rates.

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Section: Discussionmentioning

confidence: 99%

Long-term outcomes after laparoscopic colectomy

Braga¹,

Pecorelli²,

Frasson³

et al. 2011

WJGO

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“…The evolution of new minimally invasive approaches, such as Minimally Invasive Surgery (MIS) and Single Incision Laparoscopic Surgery (SILS), allows to perform the surgery by bringing the surgical instruments and endoscope to the surgical site through few or only one small incision, improving the physiological and immuno responses with respect to open surgery [6], and reducing the trauma, without compromising the surgical quality [27,31].…”

Section: Introductionmentioning

confidence: 99%

Dense soft tissue 3D reconstruction refined with super-pixel segmentation for robotic abdominal surgery

et al. 2015

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Purpose: Single Incision Laparoscopic Surgery (SILS) decreases post-operative infections, but introduces limitations in the surgeon's manoeuverability and in the surgical field of view. This work aims at enhancing intraoperative surgical visualization by exploiting the 3D information about the surgical site. An interactive guidance system is proposed wherein the pose of pre-operative tissue models is updated online. A critical process involves the intraoperative acquisition of tissue surfaces. It can be achieved using stereoscopic imaging and 3D reconstruction techniques. This work contributes to this process by proposing new methods for improved dense 3D reconstruction of soft tissues, which allows a more accurate deformation identification and facilitates the registration process.Methods: Two methods for soft tissue 3D reconstruction are proposed: Method 1 follows the traditional approach of the block matching algorithm. Method 2 performs a non-parametric Modified Census Transform to be more robust to illumination variation. The Simple Linear Iterative Clustering (SLIC) super pixel al- gorithm is exploited for disparity refinement by filling holes in the disparity images.Results: The methods were validated using two video datasets from the Hamlyn Centre, achieving an accuracy of 2.95 mm and 1.66 mm respectively. A comparison with ground truth data demonstrated the disparity refinement procedure: (i) increases the number of reconstructed points by up to 43%; (ii) does not a↵ect the accuracy of the 3D reconstructions significantly.Conclusion: Both methods give results that compare favourably with the state-of-the-art methods. The computational time constraints their applicability in realtime, but can be greatly improved by using a GPU implementation.

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“…The more severe the surgical stress is, the suppression of the NK cell activity should become hypothetically larger. However, postoperative suppression of NK cell activity have not been uniformly smaller in laparoscopic surgery in previous reports 24) 25) .…”

Section: Discussionmentioning

confidence: 79%

Salivary Chromogranin A as a Psychosomatic Stress Marker Is Suppressed in Laparoscopic Surgery Compared with Open Surgery for Colon Cancer

Ishiyama

Sakamoto

Kamiyama

et al. 2017

Juntendo Medical Journal

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Objective: The advantages of laparoscopic surgery have been described in previous studies. The aim of this study was to objectively evaluate the benefits of laparoscopic surgery (LS) vs. conventional open surgery (OS) by measuring stress markers. were enrolled. Thirty-two of the 54 patients underwent LS and twenty-two underwent OS. Methods:Peripheral blood and saliva samples were obtained on five occasions during the perioperative period. Salivary Chromogranin A (CgA), derivatives of Reactive Oxygen Metabolite Test (d-ROMs Test), interleukin 6 (IL-6), natural killer (NK) cell activity and C-reactive protein (CRP) levels were analyzed for comparison between the two groups.Results: With respect to the clinical characteristics, the intraoperative blood loss was significantly lower, and the operating time was longer in the LS group. Early postoperative oral-intake and reduced postoperative hospitalization were observed in the LS group. The salivary CgA, serum IL-6, and CRP were significantly lower in the LS group compared with the OS group. There was no difference in the d-ROMs finding between the two groups. Conclusions:In the present study, there were significant differences in postoperative oral in-take, postoperative hospitalization, IL-6, CRP, and salivary CgA, suggesting an advantage of LS for patients with colon cancer. With respect to our finding of perioperative salivary CgA, further studies will be necessary to demonstrate the significance of this interesting and promising test.

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Immunological Effects of Laparoscopic vs Open Colorectal Surgery

Cited by 159 publications

References 39 publications

Long-term outcomes after laparoscopic colectomy

Long-term outcomes after laparoscopic colectomy

Dense soft tissue 3D reconstruction refined with super-pixel segmentation for robotic abdominal surgery

Salivary Chromogranin A as a Psychosomatic Stress Marker Is Suppressed in Laparoscopic Surgery Compared with Open Surgery for Colon Cancer

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