Effect of type of resection on plasma granulocyte elastase levels following surgery for non-small cell lung carcinoma.
The lung is the primary focus of complications associated with adult respiratory distress syndrome (ARDS) and increased activation of granulocytes has been implicated in the genesis of ARDS. In the present study, plasma granulocyte elastase levels were measured in 24 patients undergoing lung resection for non-small cell lung carcinoma. Pre-, peri- and post-operative assessments of plasma elastase levels were made of patients who underwent a partial resection (lobectomy, n = 13) and patients who underwent a complete lung resection (pneumonectomy, n = 11). Preoperatively, values were similar for both patient cohorts and did not differ from those of normal volunteers. However, immediately (1 h) post-operation, elastase levels in patients who had undergone pneumonectomy were significantly elevated (300% of baseline value, P < 0.005), whereas levels were unchanged in lobectomy patients. On the 1st post-operative day (POD), elastase levels had returned to normal in pneumonectomy patients, whilst lobectomy patients now exhibited increased plasma elastase levels which remained marginally increased until the time of discharge (P < 0.05). The determinants of granulocyte activation following lung resection remain to be elucidated but may potentially relate to ischemic reperfusion in patients undergoing lobectomy, or alternatively may simply reflect the extent of manipulation, compression and contusion of lung tissue.
Martin
P
P
Department of Cardiothoracic Surgery, Killingbeck Hospital, Leeds, UK.
Gebitekin
C
C
Gupta
N K
NK
Tian
Y
Y
Ghaffari-Nejad
M
M
Saunders
N R
NR
Walker
D R
DR
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000201:enzymology* / Q000601:surgery*; D005260:Female; D006098:Granulocytes / Q000201:enzymology*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000201:enzymology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood*; D011013:Pneumonectomy; D011184:Postoperative Period
D010196:Pancreatic Elastase