Laparoscopy And Systemic Immunity

Laparoscopic surgery causes less tissue trauma than open surgery and is likely to be associated with better preservation of systemic immune function and contribute to quicker recovery (1,8,9).

In general, immunological function is depressed after open surgery, with adverse altera- tions in cytokine levels and changes in the function of cellular components of the systemic immune response (10-12). On the contrary, the body's response to laparoscopy is one of lesser immune activation as opposed to immunosuppression (13).

The usual physiological reaction to injury is an early rise in serum stress hormone levels along with a decrease in cellular immune response. These manifests as a reduction in lymphocyte and macrophage interaction, decreased activity of natural killer

FIGURE3 ■ Immune responses to surgical trauma. Abbreviations: TNF, tumor necrosis factor; IL, interleukin, CRP, C reactive protein. Source: From Ref. 86.

FIGURE3 ■ Immune responses to surgical trauma. Abbreviations: TNF, tumor necrosis factor; IL, interleukin, CRP, C reactive protein. Source: From Ref. 86.

Postoperative C-reactive protein levels are significantly lower during the first two days after laparoscopic than after open surgery.

cells, decreased lymphocyte and neutrophil chemotaxis, and a reduction in delayed-type hypersensitivity (14).

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