Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 1Date:1 August 2010
Reviewer: Simon Ng
Reviewer's report:
Major:
This prospective study aimed to compare the cellular immune response of
laparoscopic versus open resection of colorectal cancer. The authors found that
some of the components of the immune system are less suppressed after
laparoscopic than after open surgery (especially on postoperative day 4).
The observation that laparoscopic colorectal surgery is associated with better
preservation of cellular immunity when compared with open surgery has been
repeatedly reported by other researchers; the same issue has been thoroughly
addressed by a randomized study (Leung et al. Surg Endosc 2003; 17:
1305-1310). The findings of the present study essentially do not contribute
anything new to the literature.
I have some concerns about the patient selection criteria in this study, as those
with perioperative complications were excluded. Postoperative morbidity is
usually an important outcome parameter in most studies comparing laparoscopic
and open colorectal surgery; patients with complications will often have slower
recovery. The reported faster postoperative recovery in the laparoscopic group in
this study may not be reflecting the true clinical picture, as it is merely
representing a highly selected group of patients without complications. How
many patients with complications were excluded in both groups? The comparison
of postoperative recovery and hospital stay between the two approaches would
become meaningless if all patients with complications were excluded.
Minor:
Although there was no difference in age, gender, ASA classification, and tumor
status between the two groups, the authors did not tell us about the details of
medical comorbidities in both groups, e.g. diabetes mellitus, use of steroids,
other immunological diseases, etc, that could have a major impact on the cellular
immune responses after surgery.
Discretionary:
It is difficult to appreciate the differences in immune responses between the two
groups on the box plots as presented. It would be better to use simple line
graphs.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 1Date:1 August 2010
Reviewer: Simon Ng
Reviewer's report:
Major:
This prospective study aimed to compare the cellular immune response of
laparoscopic versus open resection of colorectal cancer. The authors found that
some of the components of the immune system are less suppressed after
laparoscopic than after open surgery (especially on postoperative day 4).
The observation that laparoscopic colorectal surgery is associated with better
preservation of cellular immunity when compared with open surgery has been
repeatedly reported by other researchers; the same issue has been thoroughly
addressed by a randomized study (Leung et al. Surg Endosc 2003; 17:
1305-1310). The findings of the present study essentially do not contribute
anything new to the literature.
I have some concerns about the patient selection criteria in this study, as those
with perioperative complications were excluded. Postoperative morbidity is
usually an important outcome parameter in most studies comparing laparoscopic
and open colorectal surgery; patients with complications will often have slower
recovery. The reported faster postoperative recovery in the laparoscopic group in
this study may not be reflecting the true clinical picture, as it is merely
representing a highly selected group of patients without complications. How
many patients with complications were excluded in both groups? The comparison
of postoperative recovery and hospital stay between the two approaches would
become meaningless if all patients with complications were excluded.
Minor:
Although there was no difference in age, gender, ASA classification, and tumor
status between the two groups, the authors did not tell us about the details of
medical comorbidities in both groups, e.g. diabetes mellitus, use of steroids,
other immunological diseases, etc, that could have a major impact on the cellular
immune responses after surgery.
Discretionary:
It is difficult to appreciate the differences in immune responses between the two
groups on the box plots as presented. It would be better to use simple line
graphs.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Laparoscopic and open resection for colorectal cancer: an evaluation of
cellular immunity
Version: 1Date:1 August 2010
Reviewer: Simon Ng
Reviewer's report:
Major:
This prospective study aimed to compare the cellular immune response of
laparoscopic versus open resection of colorectal cancer. The authors found that
some of the components of the immune system are less suppressed after
laparoscopic than after open surgery (especially on postoperative day 4).
The observation that laparoscopic colorectal surgery is associated with better
preservation of cellular immunity when compared with open surgery has been
repeatedly reported by other researchers; the same issue has been thoroughly
addressed by a randomized study (Leung et al. Surg Endosc 2003; 17:
1305-1310). The findings of the present study essentially do not contribute
anything new to the literature.
I have some concerns about the patient selection criteria in this study, as those
with perioperative complications were excluded. Postoperative morbidity is
usually an important outcome parameter in most studies comparing laparoscopic
and open colorectal surgery; patients with complications will often have slower
recovery. The reported faster postoperative recovery in the laparoscopic group in
this study may not be reflecting the true clinical picture, as it is merely
representing a highly selected group of patients without complications. How
many patients with complications were excluded in both groups? The comparison
of postoperative recovery and hospital stay between the two approaches would
become meaningless if all patients with complications were excluded.
Minor:
Although there was no difference in age, gender, ASA classification, and tumor
status between the two groups, the authors did not tell us about the details of
medical comorbidities in both groups, e.g. diabetes mellitus, use of steroids,
other immunological diseases, etc, that could have a major impact on the cellular
immune responses after surgery.
Discretionary:
It is difficult to appreciate the differences in immune responses between the two
groups on the box plots as presented. It would be better to use simple line
graphs.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant