C N Gutt1, P Heinz, W Kaps, V Paolucci. 1. Department of General Surgery, Johann-Wolfgang-Goethe-University, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.
Abstract
BACKGROUND: Numerous experimental and clinical investigations indicate that the mononuclear phagocyte system (MPS) has a relevant function in terms of physiological defense against tumor metastasis and bacterial infection. Consequently, a point of major interest is the influence of surgical techniques on the MPS function. METHOD: The model investigation examines the phagocytosis activity of the rat's MPS during conventional fundoplication (group 1, n = 10), laparoscopic fundoplication using a pneumoperitoneum (group 2, n = 10), and gasless laparoscopic fundoplication (group 3, n = 10). The MPS function is evaluated by an intravascular carbon clearance test (G. Biozzi). RESULTS: The fastest carbon elimination half-life was found in group 3. By way of contrast, there was a significant increase of carbon half-life in group 2 (p < 0.005). Even group 1 caused less MPS depression (p < 0.1) than group 2. CONCLUSION: Gasless laparoscopic procedures have a favorable effect on phagocytosis activity. The CO2 pneumoperitoneum seems to be the main reason for a decreased antigen elimination in laparoscopic treatments.
BACKGROUND: Numerous experimental and clinical investigations indicate that the mononuclear phagocyte system (MPS) has a relevant function in terms of physiological defense against tumor metastasis and bacterial infection. Consequently, a point of major interest is the influence of surgical techniques on the MPS function. METHOD: The model investigation examines the phagocytosis activity of the rat's MPS during conventional fundoplication (group 1, n = 10), laparoscopic fundoplication using a pneumoperitoneum (group 2, n = 10), and gasless laparoscopic fundoplication (group 3, n = 10). The MPS function is evaluated by an intravascular carbon clearance test (G. Biozzi). RESULTS: The fastest carbon elimination half-life was found in group 3. By way of contrast, there was a significant increase of carbon half-life in group 2 (p < 0.005). Even group 1 caused less MPS depression (p < 0.1) than group 2. CONCLUSION: Gasless laparoscopic procedures have a favorable effect on phagocytosis activity. The CO2 pneumoperitoneum seems to be the main reason for a decreased antigen elimination in laparoscopic treatments.
Authors: S Takiguchi; N Matsuura; Y Hamada; E Taniguchi; M Sekimoto; M Tsujinaka; H Shiozaki; M Monden; S Ohashi Journal: Surg Endosc Date: 2000-01 Impact factor: 4.584
Authors: C N Gutt; C Kuntz; T Schmandra; A Wunsch; P Heinz; N Bouvy; M Bessler; P Sänger; J Bonjer; J Allendorf; C A Jacobi; R Whelan Journal: Surg Endosc Date: 1998-08 Impact factor: 4.584