J Korean Surg Soc.
2000 May;58(5):684-693.
Analysis of the Immune Response of a Laparoscopic Surgery between Gas and Gasless Techniques
- Affiliations
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- 1Department of Surgery, Catholic University Medical College.
Abstract
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PURPOSE: To investigate the immunologic effect of the gasless laparoscopic procedure, we compared it
with an immunologically effective, gas insuffulated (pneumoperitoneal) laparoscopic procedure. METHODS:
The temporal immune responses in two similar groups of patients randomized to gas vs gasless laparo
scopic cholecystectomy were analyzed. The patients were matched by age, weight, and operation time.
Immune parameters, including serum white blood cell count and TNF-alpha, INF-gamma, IL-6, IL-8, cortisol
and ESR levels, were assessed preoperatively and on postoperative days 1 and 3 between the two groups.
Also during the operations, cytokines were checked in cultured peritoneal macrophages. RESULTS: The
results
were as follows: 1) Serum cortisol and ESR levels were not statistically different between the
two groups. White blood cell counts were also not statistically different. 2) The preoperative and
postoperative day 1 and days 3 serum TNF-alpha, INF-gamma, IL-6, and IL-8 levels in the two group were
not statistically different. However, an immediate decrease cytokine levels was significant in both groups
after postoperative day 1. 3) Especially cytokine levels were more increased in cultured peritoneal macro
phages than in serum, but difference between the two groups was not statistically significant. CONCLUSION:
From our results the beneficial effects of immunology in a gasless laparoscopic procedure were not
different from those in a gas laparoscopic procedure. Rather, immediate preservation of the immune
function during the postoperative period was detected in both groups.