Comparative evaluation of gastrointestinal transit and immune response between laparoscopic and open gastrectomy in a porcine model.
Several reports have shown advantages of laparoscopic gastrointestinal (GI) procedures when compared with their open counterparts. The aim of this study was to assess the differences of GI transit and immune response between laparoscopic and open gastrectomy in a porcine model. Fourteen pigs were assigned to undergo partial gastrectomy, either by laparoscopy (lap group) or by laparotomy (open group). GI transit was assessed using 24 markers and measured until half of markers were evacuated. To assess immune response, we used delayed-type hypersensitivity skin antigen testing (DTH) with vaccine antigen. DTH was evaluated at 48 hours after the primary injection for induration. After 2 weeks, all animals underwent necropsy and were evaluated for adhesion formation using a scoring scale. Operation time was significantly longer in the lap group. The GI transit in the postoperative phase was significantly prolonged compared with the preoperative measured times. Postoperatively, the GI transit in the open group was significantly prolonged compared with the lap group. Immune response measured by DTH was better preserved in the lap group than in the open group. Adhesion formation was significantly less in the lap group. We concluded that laparoscopic gastrectomy resulted in faster bowel recovery and less immune suppression.
Ueda
Kazuki
K
Division of Laparoscopic & Bariatric Surgery, Department of Surgery, Weill Medical College of Cornell University, New York-Presbyterian Hospital, NY 10021, USA.
Matteotti
Ronald
R
Assalia
Ahmad
A
Gagner
Michel
M
D000818:Animals; D000942:Antigens, Bacterial / Q000276:immunology; D001428:Bacterial Vaccines / Q000276:immunology; D005743:Gastrectomy / Q000379:methods*; D005772:Gastrointestinal Transit / Q000502:physiology*; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D007108:Immune Tolerance / Q000276:immunology; D007410:Intestinal Diseases / Q000209:etiology; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D023421:Models, Animal; D011183:Postoperative Complications; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D020127:Recovery of Function / Q000276:immunology / Q000502:physiology; D013552:Swine; D013997:Time Factors; D000267:Tissue Adhesions / Q000209:etiology
D000942:Antigens, Bacterial; D001428:Bacterial Vaccines