Dual effect of laparoscopy on cell-mediated immunity

被引：33

作者：

Hajri, A ^{[1
]}

Mutter, D ^{[1
]}

Wacks, S ^{[1
]}

Bastien, C ^{[1
]}

Gury, JF ^{[1
]}

Marescaux, J ^{[1
]}

Aprahamian, M ^{[1
]}

机构：

[1] Hop Univ, IRCAD, F-67091 Strasbourg, France

来源：

EUROPEAN SURGICAL RESEARCH | 2000年 / 32卷 / 05期

关键词：

immunity cellular; gene amplification; laparoscopy;

D O I：

10.1159/000008773

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Laparoscopic influence on cell-mediated immunity and tumour evolution is controversial. The objective of the present study was to assess tumour growth and immune patterns after laparoscopy on an experimental study. Lewis rats, bearing an intrapancreatic ductal carcinoma randomly underwent one of the following 2-hour procedures: anaesthesia, laparotomy or CO2 pneumoperitoneum. Cell-mediated immunity was investigated through determination of serum IL1 beta concentrations by ELISA and INF alpha, IL6 and iNOS gene transcriptions in blood white cells and peritoneal cells by RT-PCR 1 day after operation. Tumour growth and spread patterns were assessed on anatomopathological examination 2 weeks after surgery. Tumour growth and spread were unaffected no matter what procedure was applied, but port-site seeding occurred in half of the cases undergoing laparoscopy. No significant change in acute-phase protein response, represented by IL1 beta serum concentration, was found after laparoscopy. TNF alpha, IL6 and inducible NO synthase gene transcriptions were enhanced in blood white cells and depressed in peritoneal immune cells after laparoscopy. In our experimental conditions, cell-mediated immune response to CO2 pneumoperitoneum seems to be a good systemic immune activation and a less acute peritoneal immune response as opposed to control laparoscopy. This early impairment of peritoneal macrophage immune activity, observed after a long-lasting CO2 pneumoperitoneum, might be responsible for the high rate of port site recurrence. Copyright (C) 2000 S. Karger AG,Basel.

引用

页码：261 / 266

页数：6

共 20 条

[1] Port site metastases in laparoscopic surgery - First workshop on experimental laparoscopic surgery, Frankfurt, 1997 [J].