Cellular immune response after laparoscopıc and open surgery in different age groups of rats

GİRİŞ ve AMAÇ: Bu çalışmanın amacı farklı yaş gruplarındaki sıçanlarda açık ve laparoskopik cerrahi sonrası hücresel immun yanıttaki değişiklikleri karşılaştırmaktır. YÖNTEM ve GEREÇLER: Çalışmada 24 adet Wistar albino cinsi sağlıklı dişi sıçan kullanıldı. Denek hayvanları üç gruba ayrıldı. Yavru (n=8), prepuberte (n=8), erişkin (n=8) Her grupta laparotomi (n=4) ve laparoskopi (n=4) olarak iki subgruba ayrıldı. Laparotomi orta hat kesisi ile gerçekleştirildi. Laparoskopi göbekten yerleştirilen trokar aracılığıyla yapıldı. Laparotomi ve laparoskopi tanısal amaçlı yapıldı. Ameliyat öncesi ve ameliyat sonrası ilk 24 saatte T lenfosit subgrupları (CD3+ T lenfosit, CD4+ T lenfosit, CD8+ T lenfosit) ve CD4/CD8 oranı ölçüldü. BULGULAR: Tüm yaş gruplarında açık ve laparoskopik cerrahi sonrası serum CD3+ T lenfosit, CD4+ T lenfosit, CD8+ T lenfosit sayısı ve CD4/CD8 oranı açısından istatistiksel anlamlı farklılık saptanmadı (p>0.05). TARTIŞMA ve SONUÇ: Farklı yaş gruplarında postoperatif hücresel immun yanıttaki değişiklikler açısından açık ve laparoskopik cerrahinin biribirine üstünlükleri saptanmamıştır.INTRODUCTION: The aim of this study to compare the cellular immun changes of laparoscopic and open access surgery in different age groups of rats. METHODS: Animal model was consisted of 24 Wistar albino healthy female rats. They were divided into three groups; infant (n=8), prepubertal (n=8), adult (n=8). The groups were further divided into 2 subgroups as a laparatomy (n=4) and laparoscopy (n=4). The rats underwent either laparatomy or laparoscopy. The laparatomy was made using a midline incision. The laparoscopy was performed through the umbilical port. Both laparatomy and laparoscopy were diagnostic. T lymphocyte subgroups (CD3,CD4,CD8) and CD4/CD8 ratio were measured pre and 24 hours postoperatively RESULTS: There was no statistically significant difference in serum CD3,CD4,CD8 count and CD4/CD8 ratio measured after laparoscopic and open surgery in all age groups to evaluate cellular immune response (P> 0.05). DISCUSSION AND CONCLUSION: Open surgery and laparoscopy were not superior to each other in terms of changes in the postoperative cellular immune response in different age groups

The Comparison of Open and Laparoscopic Appendectomy: Is There any Outcome Difference Between Non-Complicated and Complicated Appendicitis?

Objective: The assessment of laparoscopic appendectomy (LA) and open appendectomy (OA) in patients with noncomplicated (NCA) and complicated appendicitis (CA) was aimed for. Material and Methods: Of 279 patients with appendectomy, 135 had NCA (48.3%) (49 underwent LA) (86M, 49F, median 9 years and144 had CA (51.7%) (23 underwent LA) (98M, 46F, median 11 years). Outcome measures: Wound infection (WI), intraabdominal abscess (IA), postoperative ileus (PI), requirement of reoperation (RO), time of surgery (TOS), length of stay (LOS), duration of postoperative pain (PP), nasogastric tube (NT), intraperitoneal drainage (ID) were recorded.Results: Between OA and LA groups, there was no statistical significance in WI(3/86 vs 0/49), IA(2/86 vs 0/49), RO(2/86 vs 2/49), and PI rate (1/86 vs 2/49) in NCA group (p>0.05). The LOS(3±1.4 vs 4±1.3), NT (1.2±0.9 vs 1.8±0.6 days) and PP(0.9±0.9 vs 2.3±1.1 days) were lower in LA than OA (p0.05). In CA, patients with LA had less WI(0/23 vs 18/121) (p<0.05). NT (2±0.8 vs 2.7±1.5), PP (2.1±1.2 vs 3.2±1.5) and ID (3.1±2.3 vs 4.4±1.4) were lower in LA than OA (p<0.05).Conclusion: Laparoscopic appendectomy decreases wound infection, nasogastric tube duration, intraperitoneal drainage and pain in complicated appendicitis. The Laporoscopic approach is superior in complicated and noncomplicated appendicitis