title: Laparotomy and laparoscopy diversely affect macrophage-associated antimicrobial activity in a murine model.
abstract: BACKGROUND
  Surgical intervention-related trauma contributes largely to the development of postoperative immunosuppression, with reduced resistance to secondary bacterial infection. This study compared the impact of laparotomy versus laparoscopy on macrophage-associated bactericidal ability and examined whether laparotomy renders the host more susceptible to microbial infection.
  
  
  RESULTS
  BALB/c mice were randomized into control, laparotomy, and laparoscopy groups. Laparotomy, but not laparoscopy, significantly downregulated CR3 expression on macrophages, diminished macrophage-induced uptake and phagocytosis of E. coli and S. aureus, and impaired macrophage-mediated intracellular bacterial killing. Consistent with this, mice that underwent laparotomy displayed substantially higher bacterial counts in the blood and visceral organs as well as a significantly enhanced mortality rate following bacterial infection, whereas mice subjected to laparoscopy did not show any defects in their bacterial clearance.
  
  
  CONCLUSIONS
  Laparotomy has an adverse effect on host innate immunity against microbial infection by impairing macrophage-mediated phagocytosis and killing of the invaded bacteria. By contrast, laparoscopy appears to preserve macrophage-associated bactericidal ability, thus alleviating the development of postoperative immunosuppression.
authors.affiliation: Department of Pediatric Surgery, Affiliated Children's Hospital, Soochow University, Suzhou, China.
authors.forename: Shun Gen
authors.initials: SG
authors.lastname: Huang
authors.forename: Yi Ping
authors.initials: YP
authors.lastname: Li
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: H Paul
authors.initials: HP
authors.lastname: Redmond
authors.forename: Jiang Huai
authors.initials: JH
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology*; D001424:Bacterial Infections / Q000276:immunology / Q000473:pathology; D010535:Laparoscopy; D007813:Laparotomy; D017737:Macrophages, Peritoneal / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism / Q000382:microbiology*; D051379:Mice; D008807:Mice, Inbred BALB C; D050296:Microbial Viability / Q000187:drug effects; D023421:Models, Animal; D009569:Nitric Oxide / Q000096:biosynthesis; D010587:Phagocytosis / Q000187:drug effects; D011971:Receptors, Immunologic / Q000378:metabolism; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology
chemical_list: D000890:Anti-Infective Agents; D011971:Receptors, Immunologic; D009569:Nitric Oxide