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Immune response: Effects of operative stress in a pediatric model
- Source :
- Journal of Pediatric Surgery. 33:388-393
- Publication Year :
- 1998
- Publisher :
- Elsevier BV, 1998.
-
Abstract
- The purpose of this study is to delineate the effect of different operative procedures on the cell-mediated immune response in a pediatric animal model using the delayed type hypersensitivity (DTH) skin test.Sprague Dawley rats (1 week old) were sensitized against keyhole limpet hemocyanin (KLH). Animals were challenged 2 weeks later by an intradermal injection of KLH (0.3 mg) in sterile saline. Rats with positive DTH skin reactions at 24 and 48 hours after challenge (baseline) were divided randomly into five groups (n = 10 each): group I, unmanipulated control; group II, anesthesia; group III, anesthesia and midline extraperitoneal incision; Group IV, anesthesia and laparoscopy (pneumoperitoneum with carbon dioxide); Group V, anesthesia and midline laparotomy. Before each procedure (day 0) and on postoperative days 3 and 6, animals were again challenged intradermally with KLH (0.3 mg). DTH skin reaction was evaluated 24 and 48 hours later.A statistically significant difference (P.05) in DTH skin reaction at 24 and 48 hours was observed between postoperative days 1 to 5 in the extraperitoneal and laparotomy groups with respect to baseline and the control group. Statistically significant differences were found in postoperative days 1, 4, and 5 between laparoscopy and laparotomy. The laparoscopy group showed a statistically significant decrease in DTH skin induration on postoperative day 2 when compared with the control group. At postoperative day 7 and 8 there was no statistical difference in DTH skin response comparing baseline values or between groups.These results suggest that in a pediatric animal model, abdominal surgical procedures accompanied by extensive tissue dissection produce a cellular immunosuppression, lasting up to 7 days, which is not observed in less invasive procedures. Observations concerning lesser immunosuppressive effects of laparoscopy when compared with laparotomy in adult models, as previously described by our laboratory, were also found in this pediatric model.
- Subjects :
- medicine.medical_specialty
Cellular immunity
Time Factors
medicine.medical_treatment
chemical and pharmacologic phenomena
Rats, Sprague-Dawley
Random Allocation
Pneumoperitoneum
Stress, Physiological
Laparotomy
Immune Tolerance
medicine
Animals
Hypersensitivity, Delayed
Intradermal injection
Laparoscopy
Saline
Skin Tests
Immunity, Cellular
medicine.diagnostic_test
business.industry
Immunosuppression
General Medicine
medicine.disease
Rats
Surgery
Animals, Newborn
Surgical Procedures, Operative
Anesthesia
Pediatrics, Perinatology and Child Health
business
Complication
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 33
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....e6dca02528b8505ea1fd50fba20eb309
- Full Text :
- https://doi.org/10.1016/s0022-3468(98)90469-9