Effect Of Laparoscopy And Laparotomy Ovariostomy On Cell-mediated Immunity

Purpose:Cell-mediated immunity(CMI) is believed to influence postoperative tumor growth and inflammatory response. Understanding whether laparoscopy is or is not associated with significant immunological advantages has implications for the performance of both oncologicol resections and laparoscopy in the presence of sepsis. We studied and compared the changes in the immune system by measuring the circulating T lymphocyte subpopulation and natural killer cell subsets in patients underdoing laparoscopy ovariostomy(LO) and open ovariostomy(OO).Materials and methods:Twenty-five otherwise health women with benigh ovarian cyst undergoing either laparoscopic operation(n=13) or laparotomy(n=12) were studied in a prospective clinical trial. Blood samples were obtained on the day before operation ,postoperative day 1(POD1) and postoperative day 3(POD3).The counts of pan-T cell(CD3),helper(CD4),suppressor(CD8) and NK cell(CD16) were determined by flow cytometry. SPSS10.0 was used for statistical analysis via the Student's test. Result:1. LO patients showed a significant falls in the lever of CD3 and CD4 occurred POD1 compared with the preoperative day,and recovered on POD3;there is no significant change in the levels of CDS ,CD4/CD8 during the time of studied. However,OO patients showed a significant falls in lever of CD3,CD4 and CD4/CD8 on postoperative day 1.While the lever of CD4/CD8 recovery on PODS,the lever of CD3,CD4 still decreased evidently.2. LO patients showed no significant change of the percentages of CD 16 ,however OO patients showed a significant decrease in percentages of CD16 at POD1 and was revival at PODS compared with preoperative level.3. The median surgical time and anaesthesia time for laparoscopic procedure were shorter than for the open procedure. So as to the duration of hospital stay. The bleeding volume for laparoscopic procedure were also decreased than for the open procedure.Conclusion1. LO impose less influences on T lymphocyte subpopulations and has sooner recovery to preoperative levels compared with open surgery. In addition,there is no significantly suppressed in NK cells after laparoscopy. This is to say CMI is better preserved by laparoscopy than laparotomy.2. Compared with open surgery,there are some important advantages of laparoscopy such as a quicker postoperative recovery,reduced hospital stay,decreased bleeding volume,and earlier return to work.