Postoperative suppression of inflammatory cytokines after distal gastrectomy in elderly patients.
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.
Kishimoto
Kyo
K
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Hiraguri
Manabu
M
Koide
Naohiko
N
Hanazaki
Kazuhiro
K
Adachi
Wataru
W
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
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