Kuntz C, Wunsch A, Bay F, Windeler J, Glaser F, Herfarth C
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany.
Surg Endosc. 1998 Jul;12(7):963-7. doi: 10.1007/s004649900757.
In order to evaluate the stress and immunological response to laparoscopic and conventional colon resection we operated on male Wistar rats (350-380 g), performing either laparoscopic (n = 15) or open colon resection (n = 15). A third group (n = 10) underwent anesthesia only. Immediately before and after surgery as well as 1 and 7 days postoperatively a 1 ml sample of blood was taken from the retrobulbar veinous plexus. Stress (corticosterone) and immune parameters (neopterin and interleukin [IL] 1-beta) were measured. Furthermore, the body weight as a parameter of postoperative recovery was monitored.
The analysis of variance showed significant differences between the three groups over a period of 1 week (p < 0.0001 for corticosterone, p = 0.0854 for IL 1-beta, p = 0. 0045 for neopterin). Additionally in a t-test significant differences were found between the laparoscopic and conventional group with regard to corticosterone (p = 0.08), to neopterin (p = 0. 045), and to IL 1-beta (p = 0.0043) at the end of the operation. One week after the operation the stress and immune parameters were back to normal levels in each group except IL 1-beta, but the recovery indicated by body weight was different according to the kind of the applied operative procedure: 7 days postoperatively the rats lost 5. 99% of their body weight after open surgery and only 2.4% after laparoscopic surgery. After anesthesia only the body weight increased by about 4.8%.
Laparoscopic colon resection alters the stress and immune system of healthy rats less than open colon resection. This observation is confirmed by the quicker recovery in laparoscopically operated rats.
为了评估腹腔镜和传统结肠切除术的应激和免疫反应，我们对雄性Wistar大鼠（350 - 380克）进行手术，分别实施腹腔镜手术（n = 15）或开放式结肠切除术（n = 15）。第三组（n = 10）仅接受麻醉。在手术前、后即刻以及术后1天和7天，从球后静脉丛采集1毫升血液样本。检测应激（皮质酮）和免疫参数（新蝶呤和白细胞介素[IL] 1-β）。此外，监测体重作为术后恢复的参数。
方差分析显示，在1周的时间内三组之间存在显著差异（皮质酮p < 0.0001，IL 1-β p = 0.0854，新蝶呤p = 0.0045）。另外，在t检验中发现，在手术结束时，腹腔镜组和传统组在皮质酮（p = 0.08）、新蝶呤（p = 0.045）和IL 1-β（p = 0.0043）方面存在显著差异。术后1周，除IL 1-β外，每组的应激和免疫参数均恢复到正常水平，但根据所采用的手术方式不同，体重恢复情况有所差异：术后7天，开放式手术后大鼠体重减轻5.99%，而腹腔镜手术后仅减轻2.4%。仅接受麻醉后，体重增加约4.8%。
腹腔镜结肠切除术对健康大鼠应激和免疫系统的影响小于开放式结肠切除术。腹腔镜手术大鼠恢复更快证实了这一观察结果。
