Ana Belén Martínez1, J Longás2, J M Ramírez3. 1. Faculty of Medicine, University of Zaragoza, Zaragoza, Spain. amarmar@unizar.es. 2. Department of Anesthesia, Lozano Blesa Hospital, Zaragoza, Spain. 3. Department of Surgery, Lozano Blesa Hospital, Zaragoza, Spain.
Abstract
PURPOSE: Given the high mortality and morbidity associated with colon cancer worldwide and the advantages inherent to the use of the laparoscopy technique with respect to open surgery in oncological colorectal surgery, a study was designed to observe and compare the lymphocyte activation model between open surgery (OS) and laparoscopic surgery (LS) for this type of patient as part of an ERAS protocol. METHODS: A prospective study was conducted with 38 patients who underwent surgery due to colorectal disease and were included in an ERAS protocol. The patients were divided into two groups: G1 (patients who had undergone OS; n = 19) and G2 (patients who had undergone LS; n = 19). The lymphocyte activation model was studied at three times: immediately prior to surgery and on post-operative days 1 and 3 (POD0, POD1 and POD3). RESULTS: The Th lymphocyte activation markers studied (CD25, CD69, HLADR) exhibited a significantly higher mean value on POD0 for CD69 in OS than in LS (p = 0.037) and a significantly lower mean HLADR value on POD3 for OS than for LS (p = 0.040). No statistically significant differences were observed in either the evolution or in the mean values for the intracellular cytokines studied responsible for a Th1, Th2 or Th17 response. A Th1 response pattern was observed in both OS and LS. CONCLUSIONS: The lymphocyte activation model in OS and LS is a Th1 response in both cases. The findings for the Th lymphocyte activation markers could indicate a better preserved immunity in LS with respect to OS.
PURPOSE: Given the high mortality and morbidity associated with colon cancer worldwide and the advantages inherent to the use of the laparoscopy technique with respect to open surgery in oncological colorectal surgery, a study was designed to observe and compare the lymphocyte activation model between open surgery (OS) and laparoscopic surgery (LS) for this type of patient as part of an ERAS protocol. METHODS: A prospective study was conducted with 38 patients who underwent surgery due to colorectal disease and were included in an ERAS protocol. The patients were divided into two groups: G1 (patients who had undergone OS; n = 19) and G2 (patients who had undergone LS; n = 19). The lymphocyte activation model was studied at three times: immediately prior to surgery and on post-operative days 1 and 3 (POD0, POD1 and POD3). RESULTS: The Th lymphocyte activation markers studied (CD25, CD69, HLADR) exhibited a significantly higher mean value on POD0 for CD69 in OS than in LS (p = 0.037) and a significantly lower mean HLADR value on POD3 for OS than for LS (p = 0.040). No statistically significant differences were observed in either the evolution or in the mean values for the intracellular cytokines studied responsible for a Th1, Th2 or Th17 response. A Th1 response pattern was observed in both OS and LS. CONCLUSIONS: The lymphocyte activation model in OS and LS is a Th1 response in both cases. The findings for the Th lymphocyte activation markers could indicate a better preserved immunity in LS with respect to OS.
Entities:
Keywords:
Colorectal cancer; ERAS; Immunological response after surgery; Laparoscopic surgery; Open surgery
Authors: T W Lennard; B K Shenton; A Borzotta; P K Donnelly; M White; L M Gerrie; G Proud; R M Taylor Journal: Br J Surg Date: 1985-10 Impact factor: 6.939
Authors: Jose-M Ramirez-Rodriguez; Javier Martinez-Ubieto; Jose-L Muñoz-Rodes; Jose-R Rodriguez-Fraile; Jose-A Garcia-Erce; Javier Blanco-Gonzalez; Emilio Del Valle-Hernandez; Alfredo Abad-Gurumeta; Eugenia Centeno-Robles; Carolina Martinez-Perez; Miguel Leon-Arellano; Estibaliz Echazarreta-Gallego; Manuela Elia-Guedea; Ana Pascual-Bellosta; Elena Miranda-Tauler; Alba Manuel-Vazquez; Enrique Balen-Rivera; David Alvarez-Martinez; Jose Perez-Peña; Ane Abad-Motos; Elisabeth Redondo-Villahoz; Elena Biosta-Perez; Hector Guadalajara-Labajo; Javier Ripollés-Melchor; Cristina Latre-Saso; Elena Cordoba-Diaz de Laspra; Luis Sanchez-Guillen; Mercedes Cabellos-Olivares; Javier Longas-Valien; Sonia Ortega-Lucea; Julia Ocon-Breton; Antonio Arroyo-Sebastian; Damian Garcia-Olmo Journal: BMJ Open Date: 2020-10-27 Impact factor: 2.692