Endoscopic vs conventional hernia repair from an immunologic point of view.
BACKGROUND
In this study we tried to estimate the local surgical trauma in patients undergoing endoscopic or conventional hernia repair via the changes in peripheral blood T cell subpopulations (i. e., T-helper 1 (TH1) and TH2 cells), recently shown to be recruited differentially to inflammatory sites.


METHODS
Cells were identified flow-cytometrically by intracellular cytokine staining on a single cell level in 30 patients undergoing conventional (Shouldice) or total extraperitoneal patch (TEPP) hernia repair.


RESULTS
The TH1 cells decreased postoperatively in Shouldice patients on an average of 20.8-31.4%, whereas in TEPP patients only a minor decline (mean, 7.8-9.2%) was observed. The TH2 cells did not change significantly in TEPP patients, and a small increase (mean, 7.7%) was detected in Shouldice patients.


CONCLUSIONS
Our results suggest that the postoperative reduction in TH1 cells reflects local surgical trauma and can be helpful in evaluating different surgical procedures. When conventional and endoscopic hernia repair were compared, the latter proved less traumatizing.
Decker
D
D
Department of Surgery, University of Bonn, Sigmund-Freud-Strasse 25, 53105, Bonn, Germany.
Lindemann
C
C
Springer
W
W
Low
A
A
Hirner
A
A
von Ruecker
A
A
D000328:Adult; D016207:Cytokines / Q000097:blood*; D015536:Down-Regulation; D004724:Endoscopy / Q000009:adverse effects*; D005434:Flow Cytometry; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000276:immunology*; D018417:Th1 Cells / Q000378:metabolism*; D018418:Th2 Cells / Q000378:metabolism*; D015854:Up-Regulation
D016207:Cytokines