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Erschienen in:
01.11.2011 | Review
Laparoscopic versus conventional open surgery for immune function in patients with colorectal cancer
Erschienen in: International Journal of Colorectal Disease | Ausgabe 11/2011
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Objective
To systematically evaluate the immune function in patients with colorectal cancer after laparoscopic surgery (LS) and conventional open surgery (OS).
Methods
PUBMED, EMBASE, and the Cochrane library were searched and randomized controlled trials (RCTs) comparing the immunological difference between LS and OS were included. Two authors extracted data and assessed trial quality.
Results
Eleven studies including 695 patients were analysed. Immune-competent cells demonstrated no significant differences between LS and OS in six trials. Eight trials assessed various perioperative plasma cytokine concentrations with no significant differences in interleukin-6 (IL-6) and C-reactive protein (CRP) levels between LS and OS. However, meta-analysis showed higher T suppressor lymphocytes (CD8+) counts on postoperative days (POD) 1–3 and lower plasma levels of CRP on POD 0–1 in LS group compared with OS group.
Conclusion
Although LS groups displayed higher T suppressor lymphocyte (CD8+) counts on postoperative days (POD) 1–3 and lower plasma levels of CRP on POD 0–1, there is no sufficient evidence to support superior preservation of global immune function with LS compared to OS.