Peritoneal Cytokine Response as an Indicator of Anastomotic Leakage after Colorectal Surgery
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The clinical implications of increased cytokine levels after major surgery remain unclear. This prospective study was designed to determine the peritoneal cytokine response to elective colorectal surgery during the postoperative period to evaluate its role as an indicator of anastomotic leakage. The study comprised 40 patients; 28 (70.0%) males and 12 (30.0%) females, with mean age 49.7±12.6. All patients assigned to elective colonic or colorectal resection according to indicated operative procedure. Intraperitoneal fluid cytokines 77VF-alpha, IL-6, IL-10 and IL-1 beta levels obtained from abdominal drains were measured for five days. Four patients developed anastomotic leakage and underwent relaparotomoy. A significant increase was observed between peritoneal 77VF-alpha, IL-6, IL-10 and IL-I beta levels and postoperative days (P<0.001) in patients with anastomotic leakage, whereas they remained virtually unchanged or even tended to decrease over time in patients without anastomotic leakage. This rise preceded the day of operative confirmation by at least one day. This study supports the role of peritoneal fluid cytokines as a relevant marker for detecting postoperative anastomotic leakage after colorectal surgery in addition to clinical assessment Keywords: anastomotic leakage, peritoneal cytokines, colorectal surgery.