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%) femalciy, with mean age 49.7±12.6. All patients assigned to elective colonic or colorectal resection according ti indicated operative procedure. Intraperitoneal fluid cytokines TNF-alpim. IL-6, 1L-10 and IL-/beta levas obtained from abdominal drains were measured for jive days. Four patients developed anastomotic leakage and underwent relaparotomoy. A significant increase was observed between peritotieal TN.-alpha. IL-6, IL-10 and IL-I beta levels and postoperative days (Pc 0.001) in patients with anastomotic leakage, whereas they remained virtually unchanged or -yen tended to decrease over time in patients without anastomotic leakage. This rise preceded the da y 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.