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-I 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 TNF-alpha, IL-6, IL-10 and IL-1 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. |
