Aortic aneurysm repair is associated with a lower inflammatory response compared with surgery for inflammatory bowel disease.
BACKGROUND
Since the plasma cytokine profile reflects the body's inflammatory response to injury, this study was designed to prospectively observe the plasma cytokine levels in response to the degree of different sorts of abdominal surgical trauma.


METHODS
Plasma levels of TNF-alpha, type I TNF receptor (p55), type II TNF receptor (p75), IL-6, IL-8, IL-10, phospholipase A(2) (PLA(2)), and haptoglobin were measured peri-operatively in patients undergoing bowel resection for inflammatory bowel disease or diverticulitis (IBD) (n = 9), elective repair of abdominal aortic aneurysm (AAA) (n = 9), or laparoscopic cholecystectomy (lap chole) (n = 9).


RESULTS
The IBD patients showed a significant (p < 0.05) post-operative elevation in plasma IL-6, p55, p75, and PLA(2) levels, but no significant change in TNF-alpha, IL-8, IL-10 or haptoglobin levels. The AAA patients had a significant post-operative rise in IL-10 levels and a significant decrease in plasma haptoglobin levels, but no significant change of TNF-alpha, IL-6, IL-8, p55, p75, or PLA(2) concentrations. The lap chole patients demonstrated no significant change in any of these parameters.


CONCLUSIONS
These data show that IL-6, IL-10, p55, and p75 are markers to measure the degree of inflammatory stress associated with abdominal operative procedures and demonstrate the relative lack of a cytokine response to laparoscopic cholecystectomy.
Oldenburg
H S A
HS
Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Siroen
M P C
MP
Boelens
P G
PG
Sluijter
B J R
BJ
Pruitt
J H
JH
Naseri
A H
AH
Rauwerda
J A
JA
Meijer
S
S
Cuesta
M A
MA
van Leeuwen
P A M
PA
Moldawer
L L
LL
D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000601:surgery*; D007378:Interleukins / Q000097:blood; D008297:Male; D008875:Middle Aged; D010741:Phospholipases A / Q000097:blood; D011184:Postoperative Period; D011446:Prospective Studies; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D006242:Haptoglobins; D007378:Interleukins; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D010741:Phospholipases A