[Different impact of the laparoscopic and laparotomic approach on the immune response induced by surgical procedure].
BACKGROUND
The laparoscopic approach has been adopted to treat gastrointestinal tract malignities over the last decade. This approach has become a routine method. The laparoscopic approach has been proven to provide better short-term results. Its long-term results are similar. There has also been research into the affection of the local and systemic immune reaction following surgical procedures. Available findings reveal demonstrably diminished negative impacts on the systemic immune response after laparoscopic procedures. The research papers dealing with local immunity are only experimental and their results are heterogeneous.


OBJECTIVE
To give a literature review of the influence of a surgical procedure on the systemic and local immune response and to focus more closely on the comparison the immune response after laparoscopic and laparotomic approaches.


METHODS
Authors provide a summary of current knowledge and studies which deal with the affection of the immune system by surgical procedures. The summary is dividend into parts discussing systemic and local immune responses. The role of macrophages is elaborated on in detail depending on the type of surgical approach. The results and the above-mentioned of experimental studies and their possible impact on clinical practice are subjected to critical analysis.


CONCLUSIONS
A great majority of studies support the hypothesis that the laparoscopic approach leads to less systemic immunosuppression and thus to the lower risk of the malignant spread of disease. Comparison of the impacts of laparoscopy and of open procedures on the local immune response has not been resolved yet.
Fakulta zdravotnických studií Univerzity Pardubice, Chirurgická klinika Krajské nemocnice Pardubice a.s.
L
L
Sákra
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H
Lotková
L
L
Kohoutek
J
J
Siller
D000369:Aged, 80 and over; D016207:Cytokines / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007109:Immunity; D010535:Laparoscopy; D007813:Laparotomy; D017737:Macrophages, Peritoneal / Q000276:immunology
D016207:Cytokines