Laparoscopic surgery and the systemic immune response.
OBJECTIVE
The authors review studies relating to the immune responses evoked by laparoscopic surgery.


BACKGROUND
Laparoscopic surgery has gained rapid acceptance based on clinical grounds. Patients benefit from faster recovery, decreased pain, and quicker return to normal activities. Only more recently have attempts been made to identify the metabolic and immune responses that may underlie this clinical success. The immune responses to laparoscopy are now being evaluated in relation to the present knowledge of immune responses to traditional laparotomy and surgery in general.


METHODS
A review of the published literature of the immune and metabolic responses to laparoscopy was performed. Laparoscopic surgery is compared with the traditional laparotomy on the basis of local and systemic immune responses and patterns of tumor growth. The impact of pneumoperitoneum and insufflation gases on the immune response is also reviewed.


CONCLUSIONS
The systemic immune responses for surgery in general may not apply to laparoscopic surgery. The body's response to laparoscopy is one of lesser immune activation as opposed to immunosuppression.
Vittimberga
F J
FJ
Department of Surgery, University of Massachusetts Medical Center, Worcester 01655-0333, USA.
Foley
D P
DP
Meyers
W C
WC
Callery
M P
MP
D002245:Carbon Dioxide / Q000494:pharmacology; D006801:Humans; D007109:Immunity / Q000187:drug effects; D015850:Interleukin-6 / Q000096:biosynthesis; D010535:Laparoscopy; D007958:Leukocyte Count; D008262:Macrophage Activation; D009369:Neoplasms / Q000276:immunology / Q000473:pathology; D010537:Peritoneum / Q000276:immunology; D011028:Pneumoperitoneum, Artificial
D015850:Interleukin-6; D002245:Carbon Dioxide