title: Cytokine response in peripheral blood indicates different pathophysiological mechanisms behind anastomotic leakage after low anterior resection: a pilot study.
abstract: BACKGROUND
  Anastomotic leakage (AL) after rectosigmoid resection is a serious complication associated with high morbidity and mortality. This case-control pilot study investigated the changes in blood concentration of 10 different cytokines and 2 complement factors in relation to symptomatic AL after low anterior resection for rectosigmoid cancer.
  
  
  METHODS
  Fifty patients scheduled for resection of rectosigmoid cancer had blood samples taken the day before surgery and on post-operative days 1, 3 and 5. Four patients with symptomatic AL were identified. Twenty-two age- and disease-matched patients constituted the control group. The concentration of 10 cytokines (granulocyte macrophage colony-stimulating factor, interferon-γ, interleukin-1β, interleukin-2, interleukin-4, interleukin-5, interleukin-6, interleukin-8, interleukin-10 and tumour necrosis factor-α) and 2 complement factors (mannan-binding lectin and membrane attack complex) were measured.
  
  
  RESULTS
  The present study demonstrated that plasma concentration of interleukin-1β, interleukin-6, interleukin-8 and interleukin 10 within the first 5 post-operative days was increased in patients who developed early clinical AL, whereas there were no changes in patients with late-onset AL.
  
  
  CONCLUSIONS
  The demonstrated differences in the cytokine response in early and late AL may support the theory of different pathological mechanisms of AL.
authors.affiliation: Department of Surgery, Odense University Hospital, 5000, Odense, Denmark, markep01@gmail.com.
authors.forename: M B
authors.initials: MB
authors.lastname: Ellebæk
authors.forename: G
authors.initials: G
authors.lastname: Baatrup
authors.forename: J
authors.initials: J
authors.lastname: Gjedsted
authors.forename: C
authors.initials: C
authors.lastname: Fristrup
authors.forename: N
authors.initials: N
authors.lastname: Qvist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000097:blood* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery; D015179:Colorectal Neoplasms / Q000097:blood / Q000601:surgery*; D016207:Cytokines / Q000097:blood*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D016207:Cytokines