Immune response after laparoscopic and conventional Nissen fundoplication

Area of Science:

• Gastroenterology and immunology research.
• Surgical outcomes and immune system interactions.

Background:

• Nissen fundoplication is a surgical procedure for gastroesophageal reflux disease.
• Minimally invasive laparoscopic techniques are increasingly used in surgery.

Purpose of the Study:

• To compare immune response changes in patients undergoing laparoscopic versus conventional Nissen fundoplication.
• To evaluate tissue damage markers following different Nissen fundoplication approaches.

Main Methods:

• Prospective randomized clinical study involving 20 patients with symptomatic erosive esophagitis.
• Patients were randomized to either laparoscopic (n=10) or open (n=10) Nissen fundoplication.
• Immune markers including leukocyte counts, lymphocyte subpopulations, mitogen-induced lymphocyte proliferation, interleukin-6, C-reactive protein, albumin, cortisol, and phospholipase A2 activity were measured.

Main Results:

• Laparoscopic fundoplication was associated with reduced tissue damage markers (interleukin-6 and C-reactive protein) compared to the open approach.
• Significant changes in immune responses were observed over time in both groups.
• No significant differences in immune responses were detected between the laparoscopic and open Nissen fundoplication groups.

Conclusions:

• Laparoscopic Nissen fundoplication appears to cause less tissue damage than the conventional open method.
• Despite reduced tissue damage, the surgical approach did not differentially impact the patients' immune responses.