Macrophage function and surgery. A clinical review with special reference to phagocytosis.

Present knowledge of macrophage phagocytosis in the context of surgical trauma is reviewed. The historical and morphologic background of the reticuloendothelial system and the mononuclear phagocyte system is surveyed. The physiology of the phagocytic process and methods of measurement are summarized and the influence on phagocytosis of shock, sepsis, cancer, parenteral nutrition and surgical procedures such as liver resection and splenectomy is discussed. Conclusions are that multiple factors may depress macrophage phagocytosis during surgery and that, in order to maintain immune defence balance, traumatic manipulation of tissue and abdominal organs must be minimized.