Peritoneal and systemic cytokine response to laparotomy

Abstract

Cytokines are polypeptides produced mainly by activated leucocytes in response to infection and injury, including surgical trauma. Several reports have described the systemic cytokine response to a surgical operation, some of them in a sequential way1,2. This study was designed to determine the peritoneal and systemic cytokine response to elective abdominal surgery during the first 72 h after operation.

Production of Intraperitoneal Interleukin-6 Following Open or Laparoscopic Assisted Distal Gastrectomy

“…[6][7][8] These cytokines are released sequentially into the peritoneal cavity and the bloodstream following abdominal surgery, 16,20,21 and are important mediators of the inflammatory response at sites of injury or infection. 12 Among them, IL-6 is known to induce maturation of B-cell lymphocytes and synthesis of acute-phase proteins, including CRP in the liver.…”

“…27 Although the concentration of IL-6 in serum or plasma is widely used to assess surgical stress, the blood level of IL-6 is reported to vary widely according to the timing of sample collection, and is thus considered difficult to apply clinically. 16 It still remains controversial which type of sample should be adopted for evaluating the level of IL-6. However, no reliable data for resolving this issue have been available.…”

“…Key words: Interleukin (IL)-6 -Cytokine -Peritoneal fluid -Surgical stress -Gastric cancerLaparoscopic surgery -Gastrectomy R ecent advances in laparoscopy techniques have heralded a new era in the field of abdominal surgery, and laparoscopic approaches are now being employed for the treatment of malignant neoplasms of the stomach, colon and other organs. [1][2][3][4][5] It has been reported that levels of circulating proinflammatory cytokines such as interleukin (IL)-1 beta, IL-6, IL-8, and tumor necrosis factor (TNF)-alpha are related to the extent and severity of surgical procedures.6-8 Interleukin 6 is a sensitive and early marker of tissue damage, and in general the greater the surgical trauma, the greater the response of Many studies have shown that the level of IL-6, as an indicator of surgical stress, is significantly lower after laparoscopic surgery than after open surgery.9-15 Most of the studies reported so far have measured and analyzed the concentration of IL-6 in plasma or serum, 9,10,[12][13][14][15][16]18 and only rarely in peritoneal fluid, 11,12,15,17,19,20 and the results have indicated significant correlations between the level of IL-6 and several clinical parameters. However, there is some concern as to whether the concentration of IL-6 in peritoneal fluid adequately reflects the degree of surgical stress.…”

“…9 Many studies have shown that the level of IL-6, as an indicator of surgical stress, is significantly lower after laparoscopic surgery than after open surgery. [9][10][11][12][13][14][15] Most of the studies reported so far have measured and analyzed the concentration of IL-6 in plasma or serum, 9,10,[12][13][14][15][16]18 and only rarely in peritoneal fluid, 11,12,15,17,19,20 and the results have indicated significant correlations between the level of IL-6 and several clinical parameters. However, there is some concern as to whether the concentration of IL-6 in peritoneal fluid adequately reflects the degree of surgical stress.…”

“…Interleukin 6 is released into the abdominal cavity in response to surgical injury. 16,20,21 Therefore, the total amount of IL-6 contained in peritoneal fluid might be regarded as a gold standard for assessing the severity of local surgical stress. However, this possibility has never been fully addressed.…”