Laparotomy and laparoscopy differentially accelerate experimental flank tumour growth

• Published in: British journal of surgery Vol. 85; no. 10; pp. 1439 - 1442
• Main Authors: Da Costa, M. L., Redmond, H. P., Finnegan, N., Flynn, M., Bouchier-Hayes, D.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01-10-1998; Wiley
• Subjects: Abdomen; Animals; Biological and medical sciences; Cell Division; Cytotoxicity, Immunologic; Female; Killer Cells, Lymphokine-Activated - immunology; Killer Cells, Natural - immunology; Laparoscopy - adverse effects; Laparotomy - adverse effects; Medical sciences; Mice; Mice, Inbred C57BL; Neoplasms, Experimental - immunology; Neoplasms, Experimental - pathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tumor Cells, Cultured; Growth; Rodentia; Laparoscopy; Malignant tumor; Experimental study; Immunity; Pressure; Abdomen; Vertebrata; Mammalia; Treatment; Mouse; Abdominal disease; Surgery; Animal; Complication; Endoscopy; Laparotomy; Comparative study
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1046/j.1365-2168.1998.00853.x

Background
Surgery depresses host tumoricidal activity and may increase tumour growth. This study compared the effects of laparoscopy with laparotomy on extraperitoneal tumour growth and immune function in a murine model.
Methods
C57BL/6 female mice aged 8–10 weeks had tumours induced in the right flank (n = 45) and were randomized to undergo halothane anaesthesia only, laparoscopy or laparotomy. Flank tumour volume was assessed over 10 days. A second group of animals (n = 540) were randomized to undergo the same procedures and killed at 24, 48 and 96 h. Splenocytes were harvested for natural killer (NK) cell and lymphokine activated killer (LAK) cell cytotoxicity studies.
Results
There was a significant increase in flank tumour growth in the first 48 h after laparotomy and laparoscopy compared with controls (P<0·01). By 96 h the difference was only significant in the laparotomy group (P<0·01). Both NK and LAK cell cytotoxicities were suppressed significantly (P≤0·03) from 24 h up to 96 h following laparotomy compared with control and laparoscopy groups. There was also a significant suppression in the laparoscopy group compared with controls in the first 48 h after operation (P≤0·02).
Conclusion
Extraperitoneal tumour growth was significantly accelerated after laparotomy and correlated with significantly suppressed NK and LAK cytotoxicity for at least 4 days after operation. Laparoscopy had a shorter, less profound effect on tumour growth and immune function. © 1998 British Journal of Surgery Society Ltd