Skip to main content
SpringerLink
Log in

Peritoneal macrophage and blood monocyte functions after open and laparoscopic-assisted cecectomy in rats

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background: It has been well established that open abdominal surgery results in systemic immunosuppression postoperatively; in contrast, laparoscopic surgery is associated with significantly better preserved systemic immune function. However, when intraperitoneal (local) immune function is considered, laparoscopic procedures done under a CO2 pneumoperitoneum (pneumo) have been shown to result in greater immunosuppression compared to that of open surgery. Few studies have simultaneously assessed systemic and local immune function. The purpose of this study was to assess peripheral blood mononuclear cell (PBMC) and peritoneal macrophage tumor necrosis factor-α (TNF-α) levels, H2O2 production, and MHC class II antigen expression after open and laparoscopically assisted cecectomy in a rat model. Methods: A total of 75 Sprague Dawley rats were used for three separate experiments. For each study, rats were randomly divided into three groups: anesthesia alone (AC), laparoscopic-assisted cecectomy (LC), and open cecectomy via full laparotomy (OP). A CO2 pneumo was used for laparoscopic operations. On postoperative day 1 the animals were sacrificed, macrophages were harvested via intraperitoneal lavage, and PBMCs were isolated from whole blood obtained by cardiac puncture. In experiment 1, macrophages and PBMC from each animal were stimulated with lipopolysaccharide, after which TNF-α levels of the supernatant were determined. In experiment 2, after stimulation with PMA, H2O2 release was assessed by measuring fluorescence. In experiment 3, via flow cytometry, the number of cells with surface MHC class II proteins were determined. Data from the three groups in each experiment were compared using analysis of variance Tukey-Kramer tests. Results: Macrophages and PBMC from mice in the OP group released significantly more TNF-α than cells from mice in the LC (p < 0.05) or AC (p < 0.05) groups. Macrophages from mice in the OP group released significantly less H2O2 than cells from the AC (p < 0.01) and LC (p < 0.05) groups. There was no difference between the AC and LC results. No significant differences in PBMC H2O2 release were noted among any of the groups. OP group macrophages expressed significantly less MHC class II antigen than did AC group macrophages (p < 0.05). No differences were noted among the LC results and either the OP or AC group’s outcomes. No differences were noted in PBMC MHC class II expression among any of the groups. Conclusions: In all instances, the LC group’s macrophage results were similar to the AC group’s results. OC group macrophages produced significantly more TNF-α and less H2O2 than both the AC and LC groups. MHC class II protein expression was less for the OC group than for the AC group. OC group PBMCs produced more TNF-α. No differences in PBMC H2O2 release or MHC class II expression were noted. Laparoscopic methods better preserves the baseline values of the parameters studied.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8

Similar content being viewed by others

References

  1. JDF Allendorf M Bessler RL Whelan M Trokel DA Laird MB Terry MR Treat (1996) ArticleTitleBetter preservation of immune function after laparoscopic-assisted vs open bowel resection in a murine model. Dis Colon Rectum 39 IssueIDsuppl S67–S72 Occurrence Handle1:STN:280:BymH38fksVM%3D Occurrence Handle8831550

    CAS  PubMed  Google Scholar 

  2. J Allendorf M Bessler RL Whelan M Trokel DA Laird MB Terry MR Treat (1997) ArticleTitlePostoperative immune function varies inversely with degree of surgical trauma. Surg Endosc 11 427–501

    Google Scholar 

  3. IB Brune W Wilke T Hensler B Holzmann JR Siewert (1999) ArticleTitleDown regulation of T helper type 1 immune response and altered pro-inflammatory and anti-inflammatory T cell cytokine balance following conventional but not laparoscopic surgery. Am J Surg 177 55–60 Occurrence Handle10.1016/S0002-9610(98)00299-2 Occurrence Handle1:STN:280:DyaK1M7lsV2isQ%3D%3D Occurrence Handle10037309

    Article  CAS  PubMed  Google Scholar 

  4. NV Christou R Superina M Broadhead JL Meakins (1982) ArticleTitlePostoperative depression of host resistance: determinants and effect of peripheral protein-sparing therapy. Surgery 92 786–792 Occurrence Handle1:STN:280:BiyD3MjhtlQ%3D Occurrence Handle7123498

    CAS  PubMed  Google Scholar 

  5. D Decker M Schondorf F Bidlingmaier A Hirner AA von Ruecker (1996) ArticleTitleSurgical stress induces a shift in the type-1/type-2 T-helper cell balance, suggesting downregulation of cell mediated and upregulation of antibody-mediated immunity commensurate to the trauma. Surgery 119 316–325 Occurrence Handle1:STN:280:BymB3c3lsFY%3D Occurrence Handle8619187

    CAS  PubMed  Google Scholar 

  6. CN Gutt P Heinz W Kaps V Paolucci (1997) ArticleTitleThe phagocytosis activity during conventional and laparoscopic operations in the rat. A preliminary study. Surg Endosc 11 899–901 Occurrence Handle10.1007/s004649900482 Occurrence Handle1:STN:280:ByiH3sbptFc%3D

    Article  CAS  Google Scholar 

  7. JH Hammer HJ Nielsen F Moesgaard H Kehlet (1992) ArticleTitleDuration of postoperative immunosuppression assessed by repeated delayed type hypersensitivity skin test. Eur Surg Res 24 133–137 Occurrence Handle1:STN:280:By2A283mslA%3D Occurrence Handle1499601

    CAS  PubMed  Google Scholar 

  8. T Iwanaka MS Arkovitz G Arya MM Ziegler (1997) ArticleTitleEvaluation of operative stress and peritoneal macrophage function in minimally invasive operations. J Am Coll Surg 184 357–363 Occurrence Handle1:STN:280:ByiB2Mrjtlc%3D Occurrence Handle9100680

    CAS  PubMed  Google Scholar 

  9. CA Janeway Jr R Medzhitov (1999) ArticleTitleLipoproteins take their toll on the host. Curr Biol 9 R879–R882 Occurrence Handle10.1016/S0960-9822(00)80073-1 Occurrence Handle1:STN:280:DC%2BD3c%2Fns1yktA%3D%3D Occurrence Handle10607553

    Article  CAS  PubMed  Google Scholar 

  10. T Kloosterman ME von Blomberg P Borgstein MA Cuesta RJ Scheper S Meijer (1994) ArticleTitleUnimpaired immune functions after laparoscopic cholecystectomy. Surgery 115 424–428 Occurrence Handle1:STN:280:ByuB3MfnvVY%3D Occurrence Handle8165532

    CAS  PubMed  Google Scholar 

  11. SW Lee JC Southall NR Gleason EH Huang M Bessler RL Whelan (2000) ArticleTitleTime course of differences in lymphocyte proliferation rates after laparotomy vs CO2 insufflation. Surg Endosc 14 145–148 Occurrence Handle10.1007/s004649900087 Occurrence Handle1:STN:280:DC%2BD3c7isVSqsQ%3D%3D Occurrence Handle10656948

    Article  CAS  PubMed  Google Scholar 

  12. TW Lennard BK Shenton A Borzotta PK Donnelly M White LM Gerrie G Proud RM Taylor (1985) ArticleTitleThe influence of surgical operations on components of the human immune system. Br J Surg 72 771–776 Occurrence Handle1:STN:280:BimD3c7itF0%3D Occurrence Handle2412626

    CAS  PubMed  Google Scholar 

  13. J Ordemann CA Jacobi W Schwenk R Stösslein JM Müller (2001) ArticleTitleCellular and humoral inflammatory response after laparoscopic and conventional colorectal resections. Surg Endosc 15 600–608

    Google Scholar 

  14. HP Redmond WG Watson T Houghton C Condron RGK Watson D Boucher-Hayes (1994) ArticleTitleImmune function in patients undergoing open vs laparoscopic cholecystectomy. Arch Surg 129 1240–1246 Occurrence Handle1:STN:280:ByqD2sjkvVI%3D Occurrence Handle7986152

    CAS  PubMed  Google Scholar 

  15. L Rink (1996) ArticleTitleRecent progress in the tumor necrosis factor-alpha field. Int Arch Allergy Immunol 111 199–209 Occurrence Handle1:CAS:528:DyaK28XmvFWku7Y%3D Occurrence Handle8917114

    CAS  PubMed  Google Scholar 

  16. M Sare O Yesilada M Gurel M Balkaya S Yologlu K Fiskin (1997) ArticleTitleEffects of CO2 insufflation on bacterial growth in rats with Escherichia coli-induced experimental peritonitis. Surg Laparosc Endosc 7 38–41 Occurrence Handle10.1097/00019509-199702000-00010 Occurrence Handle1:STN:280:ByiC1cjoslc%3D Occurrence Handle9116945

    Article  CAS  PubMed  Google Scholar 

  17. C Sietses MJ Wiezer QA Eijsbouts RH Beelen PA van Leeuwen BM von Blomberg S Meijer MA Cuesta (1999) ArticleTitleA prospective randomized study of the systemic immune response after laparoscopic and conventional Nissen fundoplication. Surgery 126 5–9 Occurrence Handle10.1067/msy.1999.98702 Occurrence Handle1:STN:280:DyaK1MzkslWguw%3D%3D Occurrence Handle10418585

    Article  CAS  PubMed  Google Scholar 

  18. MJ Trokel M Bessler MR Treat RL Whelan R Nowygrod (1994) ArticleTitlePreservation of immune response after laparoscopy. Surg Endosc 8 1385–1388

    Google Scholar 

  19. RW Watson HP Redmond J McCarthy PE Burke DB Hayes (1995) ArticleTitleExposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model. Br J Surg 82 1060–1065 Occurrence Handle1:STN:280:ByqA2snhvF0%3D Occurrence Handle7648154

    CAS  PubMed  Google Scholar 

  20. MA West DJ Hackam J Baker JL Rodriguez J Bellingham OD Rotstein (1997) ArticleTitleMechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery. Ann Surg 226 179–190 Occurrence Handle10.1097/00000658-199708000-00010 Occurrence Handle1:STN:280:ByiH2c7gslA%3D Occurrence Handle9296512

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported, in part, by an educational grant from the United States Surgical Corporation (Norwalk, CT, USA).

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, New York Presbyterian Hospital, Cornell-Weill University, New York, NY, 10021, USA

    S. W. Lee

  2. Laparoscopic Physiology Laboratory, Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA

    D. L. Feingold, J. J. Carter, C. Zhai, G. Stapleton, N. Gleason & R. L. Whelan

Authors
  1. S. W. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. L. Feingold
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. J. Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Zhai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Stapleton
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N. Gleason
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. L. Whelan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. L. Whelan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, S., Feingold, D., Carter, J. et al. Peritoneal macrophage and blood monocyte functions after open and laparoscopic-assisted cecectomy in rats . Surg Endosc 17, 1996–2002 (2003). https://doi.org/10.1007/s00464-003-8154-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-003-8154-5

Keywords

Search

Navigation