Peritoneal release of TNFα and IL-6 after elective colorectal surgery and anastomotic leakage

被引:32
作者
Bertram, P
Junge, K
Schachtrupp, A
Götze, C
Kunz, D
Schumpelick, V
机构
[1] Rhenish Westphalian Tech Univ, Dept Surg, Aachen, Germany
[2] Rhenish Westphalian Tech Univ, Inst Clin Chem & Pathobiochem, Cent Lab, Aachen, Germany
关键词
anastomotic leakage; peritoneal cytokine release; peritoneal fluid; peritoneum; TNF alpha and IL-6 measurement; wound healing;
D O I
10.1080/08941930390194398
中图分类号
R61 [外科手术学];
学科分类号
摘要
The evaluation of postoperative peritoneal drainage fluid tumor necrosis factor (TNF)alpha and interleukin (IL)-6 was studied prospectively over a 7-day period in 25 patients operated on for neoplastic colorectal diseases. In 22 cases, colon or rectum carcinoma was the reason for surgery, and in 3 patients resection was performed because of colonic adenoma. All patients received either an end-to-end colo-colonic or colorectal anastomosis. Of this group, 22 patients were free of complications defined as uneventful postoperative course without any signs of anastomotic leakage until the 14th postoperative day. All of these patients showed a significant rise in peritoneal TNFalpha with maximum on the 7th day during the study period ( p < .05). In contrast, peritoneal IL-6 levels remained constant without significant change in time (p > .05). Three patients underwent relaparotomy because of anastomotic leakage. In these patients, peritoneal TNFalpha concentrations showed a rise until the day of operative confirmation of anastomotic leakage. This rise preceded the day of operative confirmation by at least 1 day but did not change significantly in time (p = .59). Peritoneal IL-6 concentrations in patients with anastomotic leakage remained constant and also did not change significantly in time (p = .21). After elective colorectal surgery, neither postoperative abdominal drainage fluid TNFalpha nor IL-6 monitoring is helpful to decide on the need for revision in patients with anastomotic leakage.
引用
收藏
页码:65 / 69
页数:5
相关论文
共 8 条
[1]   Peritoneal and systemic cytokine response to laparotomy [J].
Badia, JM ;
Whawell, SA ;
ScottCoombes, DM ;
Abel, PD ;
Williamson, RCN ;
Thompson, JN .
BRITISH JOURNAL OF SURGERY, 1996, 83 (03) :347-348
[2]   Peritoneal cytokine release after elective gastrointestinal surgery and postoperative complications [J].
Henegouwen, MIV ;
van der Poll, T ;
van Deventer, SJH ;
Gouma, DJ .
AMERICAN JOURNAL OF SURGERY, 1998, 175 (04) :311-316
[3]   Early identification of peritonitis by peritoneal cytokine measurement [J].
Herwig, R ;
Glodny, B ;
Kühle, C ;
Schlüter, B ;
Brinkmann, OA ;
Strasser, H ;
Senninger, N ;
Winde, G .
DISEASES OF THE COLON & RECTUM, 2002, 45 (04) :514-521
[4]  
HOLZHEIMER RG, 1995, ARCH SURG-CHICAGO, V130, P1314
[5]  
PROBST T, 1993, EUR J CLIN INVEST, V23, P832
[6]   Limits of peritoneal cytokine measurements during abdominal lavage treatment for intraabdominal sepsis [J].
Scheingraber, S ;
Bauerfeind, F ;
Böhme, J ;
Dralle, H .
AMERICAN JOURNAL OF SURGERY, 2001, 181 (04) :301-308
[7]  
TSUKADA K, 1993, EUR J SURG, V159, P475
[8]   HIGH-LEVELS OF TUMOR-NECROSIS-FACTOR-ALPHA AND INTERLEUKIN-6 IN THE ASCITIC FLUID OF CIRRHOTIC-PATIENTS WITH SPONTANEOUS BACTERIAL PERITONITIS [J].
ZENI, F ;
TARDY, B ;
VINDIMIAN, M ;
COMTET, C ;
PAGE, Y ;
CUSEY, I ;
BERTRAND, JC .
CLINICAL INFECTIOUS DISEASES, 1993, 17 (02) :218-223