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KMID : 0978820060090010005
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2006 Volume.9 No. 1 p.5 ~ p.14
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Comparison of Immune Related Factors between Open and Laparoscopic Colectomy in Colorectal Cancer Patients
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Park Chi-Min
Yun Seong-Hyeon
Chun Ho-Kyung
Lee Woo-Yong
Han Sang-Ah
Kang Shin-Jea
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Abstract
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Purpose: The purpose of this study was to evaluate the perioperative change of immune related factors in laparoscopic colectomy compared with conventional open colectomy for the patients with colorectal cancer.
Methods: From April to August 2002, 13 patients who underwent elective laparoscopic colectomy were compared to 13 patients who received elective open colectomy for colorectal cancer. Prospective controlled study was done by analyzing the inflammatory factor (ESR, CRP, WBC) the cellular immunity (T, B, T4, T8 lymphocyte, NK cell, CD4/CD8 ratio) and the humoral immunity (IgG, IgA, IgM, C3, C4) preoperatively, on the first and fifth operative day respectively.
Results: The clinicopathologic characteristics were not different between two group, but the operation time was taken longer in the laparoscopic colectomy than open colectomy significantly (p=0.001). Acute inflammatory factors and humoral immunity were not different between two groups statistically. In cellular function, all factors were decreased in both group at immediately postoperative period, but B lymphcyte and NK cell were not change with statistic significance in the laparoscopic group. At postoperative fifth day, total lymphocyte count, T, B and T4 lymphcyte were recovered up to preoperative level in the laparoscopic group, but not in open surgery group. 3 years disease free survival rate was not different between two group.
Conclusion: Postoperative cellular immunity was seemed to be better preserved and recovered after laparoscopic colectomy than conventional open colectomy. Further study should be carried out to define the immune changes of laparoscopic surgery compared with open surgery with more parameter and patients.
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KEYWORD
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Colorectal cancer, Colectomy, Laparoscopic surgery, Cellular immunity, Humoral immunity
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