Comparison of inflammatory responses following robotic and open colorectal surgery: a prospective study

Zawadzki, Marek; Krzystek−Korpacka, Małgorzata; Gamian, Andrzej; Witkiewicz, Wojciech

doi:10.1007/s00384-016-2697-0

Cited by 30 publications

(35 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings of increased inflammation caused by elevated hsCRP, WBC and IL-6 with a differentiated response depending on mode of surgery are consistent with other trials in endometrial cancer surgery and in colorectal surgery, as is likewise the significant thrombocytosis we found, independent of the mode of surgery (Pilka, et al 2016, Zawadzki, et al 2017, Mohamud, et al 2018).…”

Section: Cortisolsupporting

confidence: 92%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

View full text Add to dashboard Cite

Objectives: The overall purpose of this thesis was to find medical and surgical treatment methods of improving the perioperative care of gynaecological cancer patients. The specific objectives were to determine whether a single dose tranexamic acid given immediately before surgery for presumed advanced ovarian cancer reduces perioperative blood loss and the need for blood transfusions, and to determine whether postoperative recovery, tissue damage, and inflammatory response markers differ between women operated with robotic and abdominal hysterectomy for low-risk endometrial cancer in an enhanced recovery after surgery (ERAS) programme, and to evaluate costs for hospital stay and postoperative recovery in relation to health impact. Material and Methods: The thesis was based on two randomised trials. The first trial was a randomised double-blind placebo-controlled multicentre study conducted in four hospitals in the southeast and central of Sweden between March 2008 and May 2012. One hundred women with presumed advanced ovarian cancer who had been scheduled for radical debulking surgery were included; 50 received tranexamic acid and 50 received a placebo. The main outcomes were blood loss and red blood cell transfusions. The second trial was a randomised open single centre trial at a Swedish university hospital, which included 50 women with low-risk endometrial cancer scheduled for radical surgery between February 2012 and May 2016; 25 women underwent robotic hysterectomy and 25 had abdominal hysterectomy. Anaesthesia and perioperative care followed an ERAS protocol in both groups. The EuroQol Group form EQ-5D-3L and the Short Form-36 evaluated the health-related quality of life. The Swedish Postoperative Symptoms Questionnaire assessed symptoms perioperatively until six weeks postoperatively. Venous blood samples were collected on several occasions until six weeks postoperatively and were analysed for markers reflecting inflammatory response and tissue damage. In addition, a health-economy analysis was conducted comparing total costs, quality-adjusted life years (QALYs) and cost per QALY between the surgical methods. Results: Total blood loss volume and transfusion rate following surgery in advanced ovarian cancer were significantly lower in the tranexamic group compared with the placebo group. Women with early endometrial cancer treated by robotic hysterectomy recovered significantly faster in the EQ-5D health index, and reached their preoperative level nearly two weeks earlier than the abdominal group. Differences regarding improvement in health-related quality of life (Short Form-36) comprising general health and social functioning were more favourable in the robotic hysterectomy group. Consumption of analgesics, pain intensity, postoperative symptom sum score and length of hospital stay were equal between the groups. The occurrence of complications was an independent risk factor and influenced most of the outcome measures adversely. Postoperative inflammatory response and tissue damage were lower after roboti...

show abstract

Section: Cortisolsupporting

confidence: 92%

On Quality Improvement in Gynaecological Cancer Surgery

Lundin

2020

Linköping University Medical Dissertations

View full text Add to dashboard Cite

show abstract

“…This pioneering study, however, was conducted on a limited number of patients and the results were highly dispersed, making it difficult to draw reliable conclusions. Only recently, our group showed attenuated inflammatory response following RACS manifesting itself by less pronounced increases in postoperative IL-6 and procalcitonin 20 .…”

Section: Discussionmentioning

confidence: 75%

The perioperative dynamics of IL-7 following robot-assisted and open colorectal surgery

Krzystek−Korpacka

Zawadzki²,

Szufnarowski³

et al. 2018

Sci Rep

Self Cite

View full text Add to dashboard Cite

Interleukin-7 is critical for T-cell development and displays antimicrobial and antitumor properties. It is referred to as a “critical enhancer of protective immunity”. However, there is no information on interleukin-7 dynamics following colorectal surgery. Moreover, although robot-assisted surgery is gaining popularity, data on the immune response to it is almost non-existent. In this prospective non-randomized case-control study we found interleukin-7 dynamics to differ following robot-assisted and open approach and to affect postoperative immunity. Linear increases were seen in the robotic group while a cubic pattern with a maximum at 8 h in the open one. Low preoperative interleukin-7 was associated with developing surgical site infection. In turn, higher preoperative interleukin-7 was associated with preserved immune function: less pronounced drop in lymphocyte count and higher Δlymphocyte/Δneutrophil ratio in patients undergoing robotic surgery. The changes in other cytokines, namely, interleukin-12(p70), TNFα, interferon-γ, and interleukin-10 were independently associated with interleukin-7 dynamics. In turn, relative changes in interleukin-7 were independent predictors of changes in interferon-γ, key cytokine of favourable Th1 immune response. Taken together, we demonstrated different perioperative dynamics of interleukin-7, which may contribute to favourable outcomes following robotic colorectal surgery including lower incidence of surgical site infections, milder surgery-induced lymphopenia, and beneficial interferon-γ dynamics.

show abstract

“…Hospitalization and surgery affect the normal homeostasis. This process is called Surgical Stress Response or Systemic Inflammatory Response (SIR) to surgery and involves both immune and neuro‐endocrine systems . One of the markers of SIR is C‐reactive protein (CRP).…”

Section: Introductionmentioning

confidence: 99%

“…systems. 7,8 One of the markers of SIR is C-reactive protein (CRP). It is used to detect postoperative complications resulting from surgical injury and as a useful tool to ensure a safe early discharge following colorectal surgery.…”

mentioning

confidence: 99%

C‐reactive protein as a marker of the surgical stress reduction within an ERAS protocol (Enhanced Recovery After Surgery) in colorectal surgery: A prospective cohort study

Olivares

Martínez

Torralba

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Comparison of inflammatory responses following robotic and open colorectal surgery: a prospective study

Abstract: This study shows that when compared with open colorectal surgery, robotic colorectal surgery results in a less pronounced inflammatory response and more pronounced anti-inflammatory action.

Cited by 30 publications

References 33 publications

On Quality Improvement in Gynaecological Cancer Surgery

On Quality Improvement in Gynaecological Cancer Surgery

The perioperative dynamics of IL-7 following robot-assisted and open colorectal surgery

C‐reactive protein as a marker of the surgical stress reduction within an ERAS protocol (Enhanced Recovery After Surgery) in colorectal surgery: A prospective cohort study

Contact Info

Product

Resources

About