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September 1996

Increased Tumor Establishment and Growth After Laparotomy vs Laparoscopy

Arch Surg. 1996;131(9):1003. doi:10.1001/archsurg.1996.01430210101022

We read with great interest both the correspondence from Yoshida et al and the reply from Bessler (Arch Surg. 1996;131:219-220). Observations into the effects of trauma and surgical stress on the growth of both primary tumors and metastatic deposits have been made since Tyzzer in 1913. The effect of laparoscopic procedures on immune function, particularly after laparoscopic resection of cancer, has been a recent subject of interest. We have recently shown that inspiratory muscle function is preserved after laparoscopic cholecystectomy, and this correlates with a significantly lower incidence of postoperative respiratory complications.1 Furthermore, in a previous article in the Archives,2 we demonstrated that immune function is impaired to a greater degree by open cholecystectomy as compared with laparoscopic cholecystectomy and suggested that this may be due to exposure of the peritoneal cavity to air at laparotomy. The observation by Yoshida et al that lipopolysaccharide induces bacterial translocation from

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