title: Postoperative suppression of inflammatory cytokines after distal gastrectomy in elderly patients.
abstract: OBJECTIVE
  Surgical procedures are being performed on elderly people with increasing frequency, but accordingly, postoperative complications and mortality rates are higher than for younger patients. We conducted this study to establish if cytokine responses after distal gastrectomy in elderly patients differ from those in younger patients.
  
  
  METHODS
  Twenty-one patients undergoing distal gastrectomy were divided into two groups based on age: the elderly group consisted of 10 patients aged >/=75 years, and the younger group consisted of 11 patients aged <65 years. Blood samples were collected from the patients preoperatively, and then on postoperative days (PODs) 1, 3, and 7, for analysis of interleukin (IL)-6, IL-8, IL-10, soluble tumor necrosis factor receptors (sTNF-R), and IL-1 receptor antagonist (IL-1ra); and also to measure TNF-alpha and IL-1beta after incubation with Escherichia coli lipopolysaccharide.
  
  
  RESULTS
  The IL-6 concentration and TNF-alpha on POD 1 were both significantly lower in the elderly group than in the younger group (P = 0.0058 and P = 0.022, respectively).
  
  
  CONCLUSIONS
  Cytokine profiles after distal gastrectomy in elderly patients differ from those in younger patients, with lower pro-inflammatory and inflammatory cytokine responses evident in the elderly.
authors.affiliation: Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Kyo
authors.initials: K
authors.lastname: Kishimoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Hiraguri
authors.forename: Naohiko
authors.initials: N
authors.lastname: Koide
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
authors.forename: Wataru
authors.initials: W
authors.lastname: Adachi
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D000068800:Etanercept; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008070:Lipopolysaccharides; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D011446:Prospective Studies; D053573:Receptors, Interleukin-1 Type I / Q000037:antagonists & inhibitors; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D007074:Immunoglobulin G; D053583:Interleukin-1beta; D015850:Interleukin-6; D016209:Interleukin-8; D008070:Lipopolysaccharides; D053573:Receptors, Interleukin-1 Type I; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000068800:Etanercept