대장암의 수술 전후 면역관련인자의 변화에 대한 전향적연구 - 개복수술과 복강경수술의 비교

Purpose: The Purpose of this study was to evaluate the perioperative change of immune related factors in laparoscopic coletomy compared with conventional open colectomy for the patients with colorectal cancer.<BR> Methods: From April to August 2002, 13 patients who underwent elective laparoscopic colectomy were compared to 13 patients who received elective open colectomy for colorectal cancer. Prospective controlled study was done by analyzing the inflammatory factor(ESR, CRP, WBC) the cellular immunity (T, B, T4, T8, lymphocyte, NK cell, CD4/CD8 ratio) and the humoral immunity (IgG, IgA, IgM, C3, C4) preoperatively, on the first and fifth operative day respectively.<BR> Results: The clinicopathologic characteristcs were not different between two group, but the opreation time was taken longer in the laparoscopic colectomy than open colectomy significantly (p=0.001). Acute inflammatory factors and humoral immunity were not different between two groups statistically. In cellular function, all factors were decreased in both group at immediately postoperative period, but B lymphcyte and NK cell were not change with statistic significance in the lapaoscopic group. At postoperative fifth day, total lymphocyte count, T, B and T4 lymphcyte were recovered up to preoperative level in the laparocscopic group, but not in open surgery group. 3 years disease free survival rate was not different between two group.<BR> Conclusion: Postoperative cellular immunity was seemed to be better preserved and recovered after laparoscopiv colectomy than convetioanl open colectomy. Futher study should be carried out to define the immune changes of laparoscopic surgery compared with open surgery with more parameter and patients.