The influence of laparoscopic surgery on postoperative polymorphonuclear leukocyte function |
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Authors: | C Sietses M J Wiezer Q A J Eijsbouts P A M van Leeuwen R H J Beelen S Meijer M A Cuesta |
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Institution: | (1) Department of Surgery, Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands, NL;(2) Department of Cell Biology and Immunology, Academic Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands, NL |
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Abstract: | Background: Laparoscopic surgery is thought to result in a better preservation of patients' immunological defenses. Polymorphonuclear
leukocytes (PMN) are the most important effector cells in the elimination of pathogenic microorganisms. Because little is
known about their function after laparoscopic surgery, we studied PMN phagocytosis, antigen expression, and oxygen radical
production.
Methods: In this study, 17 patients scheduled for Nissen fundoplication were randomly assigned to undergo either a laparoscopic or
conventional procedure. To study phagocytic capacity, PMN were incubated with fluorescein isothiocyanate (FITC)-labeled Staphylococcus aureus. Plasma opsonic capacity was measured by comparing PMN phagocytosis in the presence of patients' own plasma with phagocytosis
in the presence of control plasma. Cellular activation was measured by the expression of various cell surface markers and
by assessment of PMA-stimulated oxidative burst.
Results: Phagocytosis by PMN in the presence of patients' plasma was significantly lower 2 h after the conventional operation. No
decrease in phagocytosis was observed when control plasma was used, indicating a decreased opsonic capacity of plasma after
conventional surgery. No changes were observed after laparoscopic surgery. Furthermore, CD11b expression was significantly
lower after the laparoscopic approach, indicating a blunted cellular activation. A significantly lower PMA-stimulated oxidative
burst further confirmed the tempered stimulation after laparoscopic surgery.
Conclusions: Laparoscopic surgery results in a preservation of the plasma opsonic capacity, and thereby the ability of PMN to phagocytose
bacteria. Moreover, the postoperative cellular activation is reduced. The preserved phagocytosis and the blunted activation
may prevent the development of postoperative infectious complications.
Received: 12 February 1999/Accepted: 30 September 1999/Online publication: 9 August 2000 |
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Keywords: | : CD11b — Laparoscopic surgery — Leukocyte — Oxidative burst — Phagocytosis |
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