title: Thoracotomy procedures effect cytokine levels after thoracoabdominal             esophagectomy.
abstract: Pulmonary complications together with surgical complications are the most             frequent causes for morbidity and mortality after thoracoabdominal esophagectomy.             The con-tinuous improvement of surgical techniques has led to a decrease in surgical             complications, whereas up to 30% of the patients develop postoperative pulmonary             complications such as acute lung injury (ALI) or even the more severe acute respiratory             distress syndrome (ARDS), which are characterized by an acute inflammation in             the lung parenchyma and the airspace. Evidence from several studies indicates             that a complex network of inflammatory cytokines and mediators play a key role             in mediation, amplification, and perpetuation of the process of lung injury and             that the thoracotomy itself is a risk factor for developing ALI or ARDS. In this             trial, the cytokine levels of IL6, IL8 and IL10 were measured and compared in             30 patients who had undergone an extended radical thoracoabdominal esophagectomy             for esophageal cancer, via anterolateral thoracotomy (n=17) or posterolateral             thoracotomy (n=13). Patients of both groups were similar in terms of age, sex             and preoperative pulmonary function as well as in the anesthetic procedures they             have undergone. All patients displayed significantly increased serum levels of             IL6 and IL8 after thoracoabdominal esophagectomy. However, patients who were subjected             to an anterolateral thoracotomy were reported with significantly higher serum             levels of IL6 and IL8 compared to patients who had received a posterolateral thoracotomy.             Thus, the choice of the thoracotomy method during the thoracoabdominal esophagectomy             and the resultant cytokine levels may contribute to the occurrence of postoperative             pulmonary complications and may have an impact on the extent and severity of the             surgical stress.
authors: Department of General, Visceral, Vascular and Pediatric Surgery, University of the Saarlands, 66421 Homburg/Saar, Germany. ca.labor@uks.eu
authors: Vilma Oliveira
authors: VO
authors: Frick
authors: Christoph
authors: C
authors: Justinger
authors: Claudia
authors: C
authors: Rubie
authors: Stefan
authors: S
authors: Graeber
authors: Martin K
authors: MK
authors: Schilling
authors: Werner
authors: W
authors: Lindemann
mesh_terms: D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods*
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10