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Stress response to laparoscopic surgery: a review

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Abstract

Background

Laparoscopic surgery is associated with reduced surgical trauma, and therefore with a less acute phase response, as compared with open surgery. Impairment of the immune system may enhance surgical infections, port-site metastases, and sepsis. The objectives of this review was to assess immunologic consequences of benign laparoscopic surgery and to highlight controversial aspects.

Methods

A literature search on stress response to nonmalignant laparoscopic and open surgery was conducted using the MEDLINE and Cochrane databases. Cross-references from the reference list of major articles on the subject were used, as well as manuscripts published between 1993 and 2002.

Results

Local (i.e., peritoneal) immune function is affected by carbon dioxide pneumoperitoneum. The production of tumor necrosis factor and the phagocytotic capacity of peritoneal macrophages are less lowered. The systemic stress response, as determined by delayed-type hypersensitivity response and leukocyte antigen expression on lymphocytes, shows a preservation of immune function after laparoscopic surgery, as compared with conventional surgery.

Conclusions

Intraperitoneal carbon dioxide insufflation attenuates peritoneal immunity, but laparoscopic surgery is associated with a lower systemic stress response than open surgery.

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References

  1. JD Allendorf M Bessler KD Horvath MR Marvin DA Laird RL Whelan (1999) ArticleTitleIncreased tumor establishment and growth after open vs laparoscopic surgery in mice may be related to differences in postoperative T-cell function. Surg Endosc 13 233–235 Occurrence Handle10.1007/s004649900952 Occurrence Handle1:STN:280:DyaK1M7msF2jsg%3D%3D Occurrence Handle10064753

    Article  CAS  PubMed  Google Scholar 

  2. JD Allendorf M Bessler RL Whelan M Trokel DA Laird MB Terry MR Treat (1997) ArticleTitlePostoperative immune function varies inversely with the degree of surgical trauma in a murine model. Surg Endosc 11 427–430 Occurrence Handle10.1007/s004649900383 Occurrence Handle1:STN:280:ByiB1MfhvVI%3D Occurrence Handle9153168

    Article  CAS  PubMed  Google Scholar 

  3. C Balague EM Targarona M Pujol X Filella JJ Espert M Trias (1999) ArticleTitlePeritoneal response to a septic challenge: comparison between open laparotomy, pneumoperitoneum laparoscopy, and wall lift laparoscopy. Surg Endosc 13 792–796 Occurrence Handle10.1007/s004649901101 Occurrence Handle1:STN:280:DyaK1MzlvF2itg%3D%3D Occurrence Handle10430687

    Article  CAS  PubMed  Google Scholar 

  4. R Benner JJM Dongen Particlevan W Ewijk Particlevan JJ Haaijman (1998) Medische immunologie. Elsevier/Bunge Maarssen

    Google Scholar 

  5. ND Bouvy MC Giuffrida LN Tseng EW Steyerberg RL Marquet H Jeekel HJ Bonjer (1998) ArticleTitleEffects of carbon dioxide pneumoperitoneum, air pneumoperitoneum, and gasless laparoscopy on body weight and tumor growth. Arch Surg 133 652–656 Occurrence Handle10.1001/archsurg.133.6.652 Occurrence Handle1:STN:280:DyaK1c3pvFGkuw%3D%3D Occurrence Handle9637466

    Article  CAS  PubMed  Google Scholar 

  6. JJ Carter RL Whelan (2001) ArticleTitleThe immunologic consequences of laparoscopy in oncology. Surg Oncol Clin North Am 10 655–677 Occurrence Handle1:STN:280:DC%2BD3MnhtFWrtw%3D%3D

    CAS  Google Scholar 

  7. WG Cheadle MJ Hershman SR Wellhausen HC Polk SuffixJr (1991) ArticleTitleHLA-DR antigen expression on peripheral blood monocytes correlates with surgical infection. Am J Surg 161 639–645 Occurrence Handle10.1016/0002-9610(91)91247-G Occurrence Handle1:STN:280:By6A38%2FptFE%3D Occurrence Handle1862821

    Article  CAS  PubMed  Google Scholar 

  8. EG Chekan C Nataraj EM Clary TZ Hayward FJ Brody JC Stamat MC Fina WS Eubanks CJ Westcott (1999) ArticleTitleIntraperitoneal immunity and pneumoperitoneum. Surg Endosc 13 1135–1138 Occurrence Handle10.1007/s004649901189 Occurrence Handle1:STN:280:DC%2BD3c%2FivVCiug%3D%3D Occurrence Handle10556454

    Article  CAS  PubMed  Google Scholar 

  9. NV Christou JL Meakins J Gordon J Yee M Hassan-Zahraee CW Nohr HM Shizgal LD MacLean (1995) ArticleTitleThe delayed hypersensitivity response and host resistance in surgical patients 20 years later. Ann Surg 222 534–546, discussion 546–538 Occurrence Handle1:STN:280:BymD38rht1A%3D Occurrence Handle7574933

    CAS  PubMed  Google Scholar 

  10. NV Christou JL Meakins LD MacLean (1981) ArticleTitleThe predictive role of delayed hypersensitivity in preoperative patients. Surg Gynecol Obstet 152 297–301 Occurrence Handle1:STN:280:Bi6C38nntFM%3D Occurrence Handle7466576

    CAS  PubMed  Google Scholar 

  11. AM Cruickshank WD Fraser HJ Burns J Damme ParticleVan A Shenkin (1990) ArticleTitleResponse of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci (Lond) 79 161–165 Occurrence Handle1:STN:280:By%2BA28%2FlslM%3D

    CAS  Google Scholar 

  12. C Erenoglu ML Akin H Kayaoglu T Celenk A Batkin (2001) ArticleTitleIs helium insufflation superior to carbon dioxide insufflation in bacteremia and bacterial translocation with peritonitis? J Laparoendosc Adv Surg Tech A 11 69–72 Occurrence Handle10.1089/109264201750162257 Occurrence Handle1:STN:280:DC%2BD3Mrks1Ohug%3D%3D Occurrence Handle11327129

    Article  CAS  PubMed  Google Scholar 

  13. C Gabay I Kushner (1999) ArticleTitleAcute-phase proteins and other systemic responses to inflammation. N Engl J Med 340 448–454 Occurrence Handle10.1056/NEJM199902113400607 Occurrence Handle1:STN:280:DyaK1M7it1KhtA%3D%3D Occurrence Handle9971870

    Article  CAS  PubMed  Google Scholar 

  14. G Galizia G Prizio E Lieto P Castellano L Pelosio V Imperatore A Ferrara C Pignatelli (2001) ArticleTitleHemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum, and abdominal wall-lifting cholecystectomy: a prospective, randomized study. Surg Endosc 15 477–483 Occurrence Handle10.1007/s004640000343 Occurrence Handle1:STN:280:DC%2BD3M3mtl2gtg%3D%3D Occurrence Handle11353965

    Article  CAS  PubMed  Google Scholar 

  15. CA Gitzelmann M Mendoza-Sagaon MA Talamini SA Ahmad W Pegoli SuffixJr CN Paidas (2000) ArticleTitleCell-mediated immune response is better preserved by laparoscopy than laparotomy. Surgery 127 65–71 Occurrence Handle10.1067/msy.2000.101152 Occurrence Handle1:STN:280:DC%2BD3c7is1GqtQ%3D%3D Occurrence Handle10660760

    Article  CAS  PubMed  Google Scholar 

  16. M Grande GF Tucci O Adorisio A Barini F Rulli A Neri F Franchi AM Farinon (2002) ArticleTitleSystemic acute-phase response after laparoscopic and open cholecystectomy. Surg Endosc 16 313–316 Occurrence Handle10.1007/s00464-001-9042-5 Occurrence Handle1:STN:280:DC%2BD383jtVWquw%3D%3D Occurrence Handle11967686

    Article  CAS  PubMed  Google Scholar 

  17. A Gupta DI Watson (2001) ArticleTitleEffect of laparoscopy on immune function. Br J Surg 88 1296–1306 Occurrence Handle10.1046/j.0007-1323.2001.01860.x Occurrence Handle1:STN:280:DC%2BD3Mrjt1Sguw%3D%3D Occurrence Handle11578282

    Article  CAS  PubMed  Google Scholar 

  18. CN Gutt P Heinz W Kaps V Paolucci (1997) ArticleTitleThe phagocytosis activity during conventional and laparoscopic operations in the rat: a preliminary study. Surg Endosc 11 899–901 Occurrence Handle10.1007/s004649900482 Occurrence Handle1:STN:280:ByiH3sbptFc%3D Occurrence Handle9294268

    Article  CAS  PubMed  Google Scholar 

  19. CN Gutt D Hollander CH Brier ZG Kim M Lorenz (2001) ArticleTitleInfluence of laparoscopy and laparotomy on systemic and peritoneal T lymphocytes in a rat model. Int J Colorectal Dis 16 216–220 Occurrence Handle10.1007/s003840100296 Occurrence Handle1:STN:280:DC%2BD3MvntVOhtA%3D%3D Occurrence Handle11515680

    Article  CAS  PubMed  Google Scholar 

  20. A Hajri D Mutter S Wack C Bastien JF Gury J Marescaux M Aprahamian (2000) ArticleTitleDual effect of laparoscopy on cell-mediated immunity. Eur Surg Res 32 261–266 Occurrence Handle10.1159/000008773 Occurrence Handle1:STN:280:DC%2BD3M%2FpvFOiug%3D%3D Occurrence Handle11111169

    Article  CAS  PubMed  Google Scholar 

  21. P Harkki-Siren J Sjoberg J Toivonen A Tiitinen (2000) ArticleTitleClinical outcome and tissue trauma after laparoscopic and abdominal hysterectomy: a randomized controlled study. Acta Obstet Gynecol Scand 79 866–871 Occurrence Handle10.1034/j.1600-0412.2000.079010866.x Occurrence Handle1:STN:280:DC%2BD3M3jslCgtg%3D%3D Occurrence Handle11304971

    Article  CAS  PubMed  Google Scholar 

  22. MJ Hershman WG Cheadle SR Wellhausen PF Davidson HC Polk SuffixJr (1990) ArticleTitleMonocyte HLA-DR antigen expression characterizes clinical outcome in the trauma patient. Br J Surg 77 204–207 Occurrence Handle1:STN:280:By%2BC1MbkvVQ%3D Occurrence Handle2317682

    CAS  PubMed  Google Scholar 

  23. PM Hewitt SM Ip SP Kwok SS Somers K Li KL Leung WY Lau AK Li (1998) ArticleTitleLaparoscopic-assisted vs open surgery for colorectal cancer: comparative study of immune effects. Dis Colon Rectum 41 901–909 Occurrence Handle1:STN:280:DyaK1czktFGiug%3D%3D Occurrence Handle9678378

    CAS  PubMed  Google Scholar 

  24. Z Holub (2002) ArticleTitleImpact of laparoscopic surgery on immune function. Clin Exp Obstet Gynecol 29 77–81 Occurrence Handle1:STN:280:DC%2BD38vhslaisQ%3D%3D Occurrence Handle12171321

    CAS  PubMed  Google Scholar 

  25. T Iwanaka MS Arkovitz G Arya MM Ziegler (1997) ArticleTitleEvaluation of operative stress and peritoneal macrophage function in minimally invasive operations. J Am Coll Surg 184 357–363 Occurrence Handle1:STN:280:ByiB2Mrjtlc%3D Occurrence Handle9100680

    CAS  PubMed  Google Scholar 

  26. CA Jacobi T Junghans F Peter D Naundorf J Ordemann JM Muller (2000) ArticleTitleCardiopulmonary changes during laparoscopy and vessel injury: comparison of CO2 and helium in an animal model. Langenbecks Arch Surg 385 459–466 Occurrence Handle10.1007/s004230000172 Occurrence Handle1:STN:280:DC%2BD3M7hsVOkug%3D%3D Occurrence Handle11131248

    Article  CAS  PubMed  Google Scholar 

  27. CA Jacobi A Sterzel C Braumann E Halle R Stosslein L Krahenbuhl JM Muller (2001) ArticleTitleThe impact of conventional and laparoscopic colon resection (CO2 or helium) on intraperitoneal adhesion formation in a rat peritonitis model. Surg Endosc 15 380–386 Occurrence Handle10.1007/s004640000359 Occurrence Handle1:STN:280:DC%2BD38%2Fht1yiug%3D%3D Occurrence Handle11395820

    Article  CAS  PubMed  Google Scholar 

  28. D Kishi R Nezu T Ito E Taniguchi T Momiyama S Obunai S Ohashi H Matsuda (2000) ArticleTitleLaparoscopic-assisted surgery for Crohn’s disease: reduced surgical stress following ileocolectomy. Surg Today 30 219–222 Occurrence Handle10.1007/s005950050048 Occurrence Handle1:STN:280:DC%2BD3c3hsVCntA%3D%3D Occurrence Handle10752772

    Article  CAS  PubMed  Google Scholar 

  29. T Kloosterman BM Blomberg Particlevon P Borgstein MA Cuesta RJ Scheper S Meijer (1994) ArticleTitleUnimpaired immune functions after laparoscopic cholecystectomy. Surgery 115 424–428 Occurrence Handle1:STN:280:ByuB3MfnvVY%3D Occurrence Handle8165532

    CAS  PubMed  Google Scholar 

  30. C Kuntz A Wunsch C Bodeker F Bay R Rosch J Windeler C Herfarth (2000) ArticleTitleEffect of pressure and gas type on intraabdominal, subcutaneous, and blood pH in laparoscopy. Surg Endosc 14 367–371 Occurrence Handle10.1007/s004640000156 Occurrence Handle1:STN:280:DC%2BD3c3ltlymsA%3D%3D Occurrence Handle10790557

    Article  CAS  PubMed  Google Scholar 

  31. SB Lausten TM Ibrahim T El-Sefi LS Jensen B Gesser CG Larsen E Tonnesen SL Jensen (1999) ArticleTitleSystemic and cell-mediated immune response after laparoscopic and open cholecystectomy in patients with chronic liver disease: a randomized, prospective study. Dig Surg 16 471–477 Occurrence Handle10.1159/000018772 Occurrence Handle1:STN:280:DC%2BD3c3mtlaqtA%3D%3D Occurrence Handle10805546

    Article  CAS  PubMed  Google Scholar 

  32. SW Lee JC Southall NR Gleason EH Huang M Bessler RL Whelan (2000) ArticleTitleTime course of differences in lymphocyte proliferation rates after laparotomy vs CO2 insufflation. Surg Endosc 14 145–148 Occurrence Handle10.1007/s004649900087 Occurrence Handle1:STN:280:DC%2BD3c7isVSqsQ%3D%3D Occurrence Handle10656948

    Article  CAS  PubMed  Google Scholar 

  33. JT Liang MJ Shieh CN Chen YM Cheng KJ Chang SM Wang (2002) ArticleTitleProspective evaluation of laparoscopy-assisted colectomy versus laparotomy with resection for management of complex polyps of the sigmoid colon. World J Surg 26 377–383 Occurrence Handle10.1007/s00268-001-0235-9 Occurrence Handle11865378

    Article  PubMed  Google Scholar 

  34. E Malik O Buchweitz M Muller-Steinhardt P Kressin A Meyhofer-Malik K Diedrich (2001) ArticleTitleProspective evaluation of the systemic immune response following abdominal, vaginal, and laparoscopically assisted vaginal hysterectomy. Surg Endosc 15 463–466 Occurrence Handle10.1007/s004640000348 Occurrence Handle1:STN:280:DC%2BD3MzjtVCktQ%3D%3D Occurrence Handle11353962

    Article  CAS  PubMed  Google Scholar 

  35. AJ McMahon PJ O’Dwyer AM Cruikshank DC McMillan DS O’Reilly GD Lowe A Rumley RW Logan JN Baxter (1993) ArticleTitleComparison of metabolic responses to laparoscopic and minilaparotomy cholecystectomy. Br J Surg 80 1255–1258 Occurrence Handle1:STN:280:ByuD287ksVE%3D Occurrence Handle8242291

    CAS  PubMed  Google Scholar 

  36. T Menes H Spivak (2000) ArticleTitleLaparoscopy: searching for the proper insufflation gas. Surg Endosc 14 1050–1056 Occurrence Handle10.1007/s004640000216 Occurrence Handle1:STN:280:DC%2BD3M%2FovFeqtw%3D%3D Occurrence Handle11116418

    Article  CAS  PubMed  Google Scholar 

  37. M Nagelschmidt D Gerbecks T Minor (2001) ArticleTitleThe impact of gas laparoscopy on abdominal plasminogen activator activity. Surg Endosc 15 585–588 Occurrence Handle10.1007/s004640010282 Occurrence Handle1:STN:280:DC%2BD3MrksV2ntA%3D%3D Occurrence Handle11591946

    Article  CAS  PubMed  Google Scholar 

  38. SJ Neuhaus A Gupta DI Watson (2001) ArticleTitleHelium and other alternative insufflation gases for laparoscopy. Surg Endosc 15 553–560 Occurrence Handle10.1007/s004640080060 Occurrence Handle1:STN:280:DC%2BD3MrksV2guw%3D%3D Occurrence Handle11591939

    Article  CAS  PubMed  Google Scholar 

  39. SJ Neuhaus DI Watson T Ellis AM Rofe G Mathew GG Jamieson (2000) ArticleTitleInfluence of gases on intraperitoneal immunity during laparoscopy in tumor-bearing rats. World J Surg 24 1227–1231 Occurrence Handle10.1007/s002680010242 Occurrence Handle1:STN:280:DC%2BD3crht12ltA%3D%3D Occurrence Handle11071467

    Article  CAS  PubMed  Google Scholar 

  40. J Ordemann CA Jacobi W Schwenk R Stosslein JM Muller (2001) ArticleTitleCellular and humoral inflammatory response after laparoscopic and conventional colorectal resections. Surg Endosc 15 600–608 Occurrence Handle10.1007/s004640090032 Occurrence Handle1:STN:280:DC%2BD3MrksV2msg%3D%3D Occurrence Handle11591950

    Article  CAS  PubMed  Google Scholar 

  41. J Perttilä M Salo J Ovaska J Gronroos M Lavonius A Katila M Lahteenmaki K Pulkki (1999) ArticleTitleImmune response after laparoscopic and conventional Nissen fundoplication. Eur J Surg 165 21–28 Occurrence Handle10.1080/110241599750007469 Occurrence Handle10069630

    Article  PubMed  Google Scholar 

  42. JB Pietsch JL Meakins LD MacLean (1977) ArticleTitleThe delayed hypersensitivity response: application in clinical surgery. Surgery 82 349–355 Occurrence Handle1:STN:280:CSiB3snks10%3D Occurrence Handle888102

    CAS  PubMed  Google Scholar 

  43. D Poenaru NV Christou (1991) ArticleTitleClinical outcome of seriously ill surgical patients with intraabdominal infection depends on both physiologic (APACHE II score) and immunologic (DTH score) alterations. Ann Surg 213 130–136 Occurrence Handle1:STN:280:By6C38fgt1Y%3D Occurrence Handle1992939

    CAS  PubMed  Google Scholar 

  44. MI Puttick DM Scott-Coombes J Dye CC Nduka NM Menzies-Gow AO Mansfield A Darzi (1999) ArticleTitleComparison of immunologic and physiologic effects of CO2 pneumoperitoneum at room and body temperatures. Surg Endosc 13 572–575 Occurrence Handle10.1007/s004649901043 Occurrence Handle1:STN:280:DyaK1M3nvVGguw%3D%3D Occurrence Handle10347293

    Article  CAS  PubMed  Google Scholar 

  45. HP Redmond RW Watson T Houghton C Condron RG Watson D Bouchier-Hayes (1994) ArticleTitleImmune function in patients undergoing open vs laparoscopic cholecystectomy. Arch Surg 129 1240–1246 Occurrence Handle1:STN:280:ByqD2sjkvVI%3D Occurrence Handle7986152

    CAS  PubMed  Google Scholar 

  46. M Schietroma F Carlei E Lezoche A Agnifili GN Enang S Mattucci S Minervini NJ Lygidakis (2001) ArticleTitleEvaluation of immune response in patients after open or laparoscopic cholecystectomy. Hepatogastroenterology 48 642–646 Occurrence Handle1:STN:280:DC%2BD38%2FitFOnuw%3D%3D Occurrence Handle11462893

    CAS  PubMed  Google Scholar 

  47. C Sietses MJ Wiezer QA Eijsbouts PA Leeuwen Particlevan RH Beelen S Meijer MA Cuesta (2000) ArticleTitleThe influence of laparoscopic surgery on postoperative polymorphonuclear leukocyte function. Surg Endosc 14 812–816 Occurrence Handle10.1007/s004640010080 Occurrence Handle1:STN:280:DC%2BD3cvkvFGqsA%3D%3D Occurrence Handle11000359

    Article  CAS  PubMed  Google Scholar 

  48. C Sietses RH Beelen S Meijer MA Cuesta (1999) ArticleTitleImmunological consequences of laparoscopic surgery: speculations on the cause and clinical implications. Langenbecks Arch Surg 384 250–258 Occurrence Handle10.1007/s004230050200 Occurrence Handle1:STN:280:DyaK1MzmsVejsw%3D%3D Occurrence Handle10437613

    Article  CAS  PubMed  Google Scholar 

  49. VJ Smidt DM Singh JA Hurteau WW Hurd (2001) ArticleTitleEffect of carbon dioxide on human ovarian carcinoma cell growth. Am J Obstet Gynecol 185 1314–1317 Occurrence Handle10.1067/mob.2001.119079 Occurrence Handle1:STN:280:DC%2BD3MnpslKjsw%3D%3D Occurrence Handle11744902

    Article  CAS  PubMed  Google Scholar 

  50. MJ Solomon CJ Young AA Eyers RA Roberts (2002) ArticleTitleRandomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg 89 35–39 Occurrence Handle10.1046/j.0007-1323.2001.01957.x Occurrence Handle1:STN:280:DC%2BD387hvVCntg%3D%3D Occurrence Handle11851660

    Article  CAS  PubMed  Google Scholar 

  51. MJ Trokel M Bessler MR Treat RL Whelan R Nowygrod (1994) ArticleTitlePreservation of immune response after laparoscopy. Surg Endosc 8 1385–1387 Occurrence Handle1:STN:280:ByqC1cvgsVw%3D Occurrence Handle7878502

    CAS  PubMed  Google Scholar 

  52. A Uzunkoy A Coskun OF Akinci A Kocyigit (2000) ArticleTitleSystemic stress responses after laparoscopic or open hernia repair. Eur J Surg 166 467–471 Occurrence Handle10.1080/110241500750008781 Occurrence Handle1:STN:280:DC%2BD3M%2FlsFSrsw%3D%3D Occurrence Handle10890543

    Article  CAS  PubMed  Google Scholar 

  53. FJ Vittimberga B Nolan RA Perugini L Spector MP Callery (2000) ArticleTitleLaparoscopic surgery and Kupffer cell activation. Surg Endosc 14 1171–1176 Occurrence Handle10.1007/s004640010065 Occurrence Handle1:STN:280:DC%2BD3M7htFCitA%3D%3D Occurrence Handle11148792

    Article  CAS  PubMed  Google Scholar 

  54. CB Walker DM Bruce SD Heys DB Gough NR Binnie O Eremin (1999) ArticleTitleMinimal modulation of lymphocyte and natural killer cell subsets following minimal access surgery. Am J Surg 177 48–54 Occurrence Handle10.1016/S0002-9610(98)00290-6 Occurrence Handle1:STN:280:DyaK1M7lsV2isA%3D%3D Occurrence Handle10037308

    Article  CAS  PubMed  Google Scholar 

  55. RW Watson HP Redmond J McCarthy PE Burke D Bouchier-Hayes (1995) ArticleTitleExposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model. Br J Surg 82 1060–1065 Occurrence Handle1:STN:280:ByqA2snhvF0%3D Occurrence Handle7648154

    CAS  PubMed  Google Scholar 

  56. MA West J Baker J Bellingham (1996) ArticleTitleKinetics of decreased LPS-stimulated cytokine release by macrophages exposed to CO2. J Surg Res 63 269–274 Occurrence Handle10.1006/jsre.1996.0259 Occurrence Handle1:CAS:528:DyaK28XksVOms70%3D Occurrence Handle8661209

    Article  CAS  PubMed  Google Scholar 

  57. MA West DJ Hackam J Baker JL Rodriguez J Bellingham OD Rotstein (1997) ArticleTitleMechanism of decreased in vitro murine macrophage cytokine release after exposure to carbon dioxide: relevance to laparoscopic surgery. Ann Surg 226 179–190 Occurrence Handle10.1097/00000658-199708000-00010 Occurrence Handle1:STN:280:ByiH2c7gslA%3D Occurrence Handle9296512

    Article  CAS  PubMed  Google Scholar 

  58. FP Wu MA Cuesta C Sietses (2001) ArticleTitleRandomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer. Br J Surg 88 801–807 Occurrence Handle10.1046/j.1365-2168.2001.01653.x Occurrence Handle11412248

    Article  PubMed  Google Scholar 

  59. PM Yuen TW Mak SF Yim WD Kee CW Lam MS Rogers AM Chang (1998) ArticleTitleMetabolic and inflammatory responses after laparoscopic and abdominal hysterectomy. Am J Obstet Gynecol 179 1–5 Occurrence Handle1:STN:280:DyaK1czmvVCmtw%3D%3D Occurrence Handle9704757

    CAS  PubMed  Google Scholar 

  60. R Zuckerman M Gold P Jenkins LA Rauscher M Jones S Heneghan (2001) ArticleTitleThe effects of pneumoperitoneum and patient position on hemodynamics during laparoscopic cholecystectomy. Surg Endosc 15 562–565 Occurrence Handle10.1007/s004640080065 Occurrence Handle1:STN:280:DC%2BD3MrksV2nsg%3D%3D Occurrence Handle11591940

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Surgery, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

    M. Buunen, M. Gholghesaei, R. Veldkamp, D. W. Meijer, H. J. Bonjer & N. D. Bouvy

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  1. M. Buunen
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  2. M. Gholghesaei
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  3. R. Veldkamp
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  4. D. W. Meijer
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  5. H. J. Bonjer
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  6. N. D. Bouvy
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Correspondence to H. J. Bonjer.

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Buunen, M., Gholghesaei, M., Veldkamp, R. et al. Stress response to laparoscopic surgery: a review. Surg Endosc 18, 1022–1028 (2004). https://doi.org/10.1007/s00464-003-9169-7

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