ADRENOCORTICAL-RESPONSE AND REGIONAL T-LYMPHOCYTE ACTIVATION PATTERNSFOLLOWING MINIMALLY INVASIVE SURGERY IN A RAT MODEL

Background: Laparoscopic survey is associated with less tissue trauma and postoperative pain as well as a more rapid recovery than open surg ery, We hypothesized that these factors may result in less immune impa irment following laparoscopic surgery. Methods: We measured mitogen-in duced surface interleukin-2 receptor (IL2R) expression and lymphocyte proliferation in CD4(+) and CD8(+) T-lymphocytes as well as serum cort icosterone levels in rats 24 h following open (OP) and laparoscopic (L AP) fundoplication. Results: Serum corticosterone levels were lower in LAP vs OP rats (p = 0.02). CD4(+) IL2R expression was higher in the b lood, but not in the spleen, in LAP vs OP animals (p = 0.02). CD8(+) I L2R expression was similar in both groups. Mitogen-induced lymphocyte proliferation was no different in the blood but decreased in the splee n in LAP vs OP rats (p = 0.03). Conclusions: Compared to open surgery, laparoscopic fundoplication in the rat results in lower adrenocortica l hormone levels and better-preserved T-helper-cell activation in the blood. Lymphocyte proliferation is suppressed in the spleen 24 h after laparoscopic surgery. Minimally invasive surgery may better preserve cell-mediated immunity in the early postoperative period.