Surgically induced immunologic alterations in the child

Mollitt, Daniel L., Steele, Russell W., Marmer, Daniel J., Golladay, E. Stevers and Costas, Sheron (1984) Surgically induced immunologic alterations in the child. Journal of Pediatric Surgery, 19 6: 818-822. doi:10.1016/S0022-3468(84)80376-0

Author Mollitt, Daniel L.
Steele, Russell W.
Marmer, Daniel J.
Golladay, E. Stevers
Costas, Sheron
Title Surgically induced immunologic alterations in the child
Journal name Journal of Pediatric Surgery   Check publisher's open access policy
ISSN 0022-3468
Publication date 1984-01-01
Year available 1984
Sub-type Article (original research)
DOI 10.1016/S0022-3468(84)80376-0
Open Access Status Not Open Access
Volume 19
Issue 6
Start page 818
End page 822
Total pages 5
Editor Stephen L. Gans
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Language eng
Formatted abstract
Surgery is generally believed to be an immunodepressant. This assumption is based, in part, upon studies of compromised patients undergoing major operation. Similar studies in normal adults following elective procedures are contradictory and little information is available regarding the pediatric surgical patient. This paper presents a study of immune function in children undergoing elective operation. Fifty healthy preoperative children (mean age: 20 months) were randomly selected. Ninety-five percent underwent inguinal herniorrhaphy. Operative time averaged 45 minutes (range: 30 to 90 minutes). Anesthesia consisted of Halothane and Nitrous Oxide in all cases. Approximately 2.5 cc of heparinized blood and 0.5 cc of serum were obtained immediately prior to and 2 hours following operation. Half of the children underwent assays of neutrophil function including (1) absolute count, (2) random migration, (3) chemotaxis, (4) phagocytosis, and (5) bacterial killing. Serum was examined for opsonization of Staphylococcus aureus using the chemiluminescence method. The remaining children underwent lymphocytic quantitation including (1) absolute count, (2) total T cells, (3) total B cells, (4) T-helper cells, (5) T-suppressor cells, and 96) T-helper/suppressor ratio. Absolute neutrophil count increased 2.4 times preoperative values (P<0.01). There were, however, no significant alterations in neutrophil functional capabilities. Similarly, there was no alteration in serum opsonic capacity. There was a significant decrease in absolute lymphocyte count (6560-4013, P<0.01) postoperatively, and T cells, T-helper, T-suppressor, and B cells were all significantly affected (P<0.01 to 0.02). There was no change in the T-helper/suppressor ratio. The significant increase in neutrophil count with preservation of function indicates intravascular demargination. The lymphocyte changes suggest redistribution to reticuloendothelial organs. These alterations represent an appropriate mobilization of the child's immune defenses in response to the stress of surgery with no evidence of functional depression.
Keyword Pediatrics
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Special issue: Papers Presented Before the 15th Annual Meeting of the American Pediatric Surgical Association

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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