Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery

Aim. Postoperative ileus (POI) is common after surgery. Animal studies indicate that the POI mechanism involves an inflammatory response, which is also activated during postoperative complications. This study aimed to determine whether inflammatory biomarkers might facilitate an early detection of p...

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Main Authors: G. S. A. Boersema, Z. Wu, A. G. Menon, G. J. Kleinrensink, J. Jeekel, J. F. Lange
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Mediators of Inflammation
Online Access:http://dx.doi.org/10.1155/2018/7141342
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author G. S. A. Boersema
Z. Wu
A. G. Menon
G. J. Kleinrensink
J. Jeekel
J. F. Lange
author_facet G. S. A. Boersema
Z. Wu
A. G. Menon
G. J. Kleinrensink
J. Jeekel
J. F. Lange
author_sort G. S. A. Boersema
collection DOAJ
description Aim. Postoperative ileus (POI) is common after surgery. Animal studies indicate that the POI mechanism involves an inflammatory response, which is also activated during postoperative complications. This study aimed to determine whether inflammatory biomarkers might facilitate an early detection of prolonged POI (PPOI) or infectious complications. Methods. Forty-seven adult patients who underwent oncological colorectal surgery were included. They filled out a perioperative diary to report their gastrointestinal symptoms. Blood samples were collected preoperatively, and on postoperative day (POD) 1 and 3. Levels of leucocytes, C-reactive protein (CRP), interleukin (IL)-6, TNF-α, and IL-1β were analyzed. Results. Patients with PPOI had significantly longer stay in hospital than patients without (13.6 ± 10.5 versus 7.4 ± 3.2 days, p<0.001); they also had higher levels of IL-6 ratios, leucocytes, and CRP levels, but did not reach significance. Higher levels of postoperative IL-6 and CRP levels (p<0.05, resp.) were found in patients with infectious complications. The receiver operating characteristic (ROC) analysis found better diagnostic values of IL-6 ratio on both POD 1 and 3 than that of CRP (POD 1: ROC 0.825, p<0.001). Conclusion. Blood levels of inflammatory cytokines cannot predict PPOI after colorectal surgery. Instead, postoperative IL-6 changes may predict the infectious complications with a better diagnostic value than the current leukocytes or CRP tests.
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spelling doaj-art-b802e37614304814ab36ca31486ffa3c2025-02-03T06:06:05ZengWileyMediators of Inflammation0962-93511466-18612018-01-01201810.1155/2018/71413427141342Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal SurgeryG. S. A. Boersema0Z. Wu1A. G. Menon2G. J. Kleinrensink3J. Jeekel4J. F. Lange5Department of Surgery, Erasmus University Medical Center, Rotterdam, NetherlandsWard I of Gastrointestinal Cancer Center, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University Cancer Hospital & Institute, Beijing 100142, ChinaDepartment of Surgery, Havenziekenhuis, Rotterdam, NetherlandsDepartment of Neuroscience, Erasmus University Medical Center, Rotterdam, NetherlandsDepartment of Neuroscience, Erasmus University Medical Center, Rotterdam, NetherlandsDepartment of Surgery, Erasmus University Medical Center, Rotterdam, NetherlandsAim. Postoperative ileus (POI) is common after surgery. Animal studies indicate that the POI mechanism involves an inflammatory response, which is also activated during postoperative complications. This study aimed to determine whether inflammatory biomarkers might facilitate an early detection of prolonged POI (PPOI) or infectious complications. Methods. Forty-seven adult patients who underwent oncological colorectal surgery were included. They filled out a perioperative diary to report their gastrointestinal symptoms. Blood samples were collected preoperatively, and on postoperative day (POD) 1 and 3. Levels of leucocytes, C-reactive protein (CRP), interleukin (IL)-6, TNF-α, and IL-1β were analyzed. Results. Patients with PPOI had significantly longer stay in hospital than patients without (13.6 ± 10.5 versus 7.4 ± 3.2 days, p<0.001); they also had higher levels of IL-6 ratios, leucocytes, and CRP levels, but did not reach significance. Higher levels of postoperative IL-6 and CRP levels (p<0.05, resp.) were found in patients with infectious complications. The receiver operating characteristic (ROC) analysis found better diagnostic values of IL-6 ratio on both POD 1 and 3 than that of CRP (POD 1: ROC 0.825, p<0.001). Conclusion. Blood levels of inflammatory cytokines cannot predict PPOI after colorectal surgery. Instead, postoperative IL-6 changes may predict the infectious complications with a better diagnostic value than the current leukocytes or CRP tests.http://dx.doi.org/10.1155/2018/7141342
spellingShingle G. S. A. Boersema
Z. Wu
A. G. Menon
G. J. Kleinrensink
J. Jeekel
J. F. Lange
Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
Mediators of Inflammation
title Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
title_full Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
title_fullStr Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
title_full_unstemmed Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
title_short Systemic Inflammatory Cytokines Predict the Infectious Complications but Not Prolonged Postoperative Ileus after Colorectal Surgery
title_sort systemic inflammatory cytokines predict the infectious complications but not prolonged postoperative ileus after colorectal surgery
url http://dx.doi.org/10.1155/2018/7141342
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