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Adrenocortical response and regional T-lymphocyte activation patterns following minimally invasive surgery in a rat
R Berguer1, M Dalton, D Ferrick
1Department of Surgery, University of California Davis, 4301 X Street, Sacramento, CA 95817, USA.
Background:
Laparoscopic surgery is associated with less tissue trauma and postoperative pain as well as a more rapid recovery than open surgery. We hypothesized that these factors may result in less immune impairment following laparoscopic surgery.
Methods:
We measured mitogen-induced surface interleukin-2 receptor (IL2R) expression and lymphocyte proliferation in CD4+ and CD8+ T-lymphocytes as well as serum corticosterone levels in rats 24 h following open (OP) and laparoscopic (LAP) fundoplication.
Results:
Serum corticosterone levels were lower in LAP vs OP rats (p = 0.02). CD4+ IL2R expression was higher in the blood, but not in the spleen, in LAP vs OP animals (p = 0.02). CD8+ IL2R expression was similar in both groups. Mitogen-induced lymphocyte proliferation was no different in the blood but decreased in the spleen in LAP vs OP rats (p = 0.03).
Conclusions:
Compared to open surgery, laparoscopic fundoplication in the rat results in lower adrenocortical hormone levels and better-preserved T-helper-cell activation in the blood. Lymphocyte proliferation is suppressed in the spleen 24 h after laparoscopic surgery. Minimally invasive surgery may better preserve cell-mediated immunity in the early postoperative period.