The Effect On Perioperative Cellular Immunity Of Laparoscopic Colonic Surgery Compared With Conventional Surgery

Objective: Our research work is about the cellular immunity of patients with coloncancer. We focus on the effection of laparoscopic colonic surgery on perioperativecellular immunity compared with conventional surgery.We try to find out the internalcontact of the factors effect on the cellular immunity.Method: Patients with colon cancer were randomly divided into laparoscopic surgery(LS) group and conventional surgery(CS) group. Blood samples were obtainedpreoperatively and on the seventh postoperative day. The cellular immunityparameters were determined by flow cytometry（Lymphocytes classification：CD3、CD4、CD8、CD4/CD8、CD16、CD56）.Results:1.Of all the patients, non significant increases of CD3+、CD4+and NK wasobserved, the CD8+decreased significantly (P<0.05),the CD4/CD8ratio increasedsignificantly(P<0.05).The inhibition of cellular immunity caused by surgical traumalast for a short period after surgery,and the inhibiting effect became unconspicuous ina week. Some immunity parameters improved after surgery, probably because theresection of tumor reduced the inhibition of the cellular immunity.2. On day7postoperative, the patients whose pathology stage were I and II（AJCC）had more counts of NK cell than the patients whose pathology stage wereIII (P<0.05).The immune function partly concerned to the pathological staging.3. The LS group had larger counts of CD3+、CD3+CD4+than the CS group(P<0.05),and the CD4+/CD8+ratio of LS was higher than the CS on day7postoperative, the differences were not significant;The counts of NK cell were lower than the CS group (P<0.05);The counts of CD3+CD8+was lower than the CS,the difference was not significant.Conclusion:Surgical trauma might inhibit cellular immunity; The long-term cellular immunity ofpatients with malignant tumor may improve after surgery; The NK cell countsprobably concerned to the pathological staging; The immunity inhibition oflaparoscopic colorectal surgery is less than conventional surgery,and the cellulalimmunity of patients underwent laparoscopic colorectal surgery recover sooner thanthe patients underwent conventional surgery.