Kinetics of cytokines and PMN-E in thoracoscopic esophagectomy.
BACKGROUND
Perioperative increases in the levels of cytokines and polymorphonuclear leukocyte elastase (PMN-E) have been shown to be related to degree of surgical trauma.


METHODS
We measured the changes in levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and PMN-E in the perioperative period in patients undergoing thoracoscopic esophagectomy (n = 15) and conventional transthoracic esophagectomy (n = 15) for thoracic esophageal cancer.


RESULTS
Both IL-6 and IL-8 increased markedly immediately after transthoracic esophagectomy and thereafter, but only a slight increase was observed after the thoracoscopic procedure (IL-6: p = 0.047; IL-8: p = 0.03). A difference was also seen in the pattern of changes in PMN-E. Levels of PMN-E increased immediately after transthoracic esophagectomy and continued to be high up to the 3rd postoperative day, but they remained low after the thoracoscopic procedure and showed no increase (p <lt; 0.01).


CONCLUSIONS
These results suggest that, compared with transthoracic esophagectomy, thoracoscopic esophagectomy results in less production of cytokines and PMN-E and thus causes less surgical trauma.
Fukunaga
T
T
Department of Surgery, Urayasu Hospital of Juntendo University, School of Medicine, 2-1-1, Tomioka, Urayasu-shi, Chiba 279-0021, Japan. tetsu@med.juntendo.ac.jp
Kidokoro
A
A
Fukunaga
M
M
Nagakari
K
K
Suda
M
M
Yoshikawa
S
S
D016207:Cytokines / Q000096:biosynthesis / Q000097:blood*; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000096:biosynthesis / Q000097:blood*; D007962:Leukocytes / Q000201:enzymology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011184:Postoperative Period; D013906:Thoracoscopy / Q000379:methods*
D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D019272:Leukocyte Elastase