Abstract
Purpose:
To determine perioperative cellular immune responses to retroperitoneal laparoscopic radical nephrectomy by comparing them with those to open radical nephrectomy.
Methods:
Fifty-two patients with renal cell carcinoma were equally randomized into two groups: laparoscopic nephrectomy group (LN group) and open nephrectomy group (ON group) to compare differences in cellular immunofunction. The peripheral blood lymphocyte subpopulations (CD3, CD4, CD8, CD25, CD69, Fas/FasL) were detected with flow cytometry. All tests were performed before operation and at 1, 3, and 5 days after operation. All data were assessed by repeated measurement and variance analysis t test and χ 2 tests.
Results:
CD3 and CD4 levels in the ON group decreased significantly 1 day and 3 days after operation but recovered on day 5; CD8 level (5 days after operation) in the ON group was significantly higher than that in the LN group. CD25 level (3 days after operation) in the LN group was significantly higher than that in the ON group. CD69 level 3 days after operation in the ON group was significantly higher than that in the LN group. In the ON group, CD69 increased markedly 3 days after operation. FasL level (in both the LN and ON groups) was higher than the normal reference; Fas and FasL in the ON group were higher than those in the LN group.
Conclusion:
The perioperative immune response is less obvious after a laparoscopic procedure compared with a conventional approach in patients with renal cell carcinoma.
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