title: Peritoneal mast cell degranulation and gastrointestinal recovery in patients undergoing colorectal surgery.
abstract: BACKGROUND
  Degranulation of peritoneal mast cells (MCs) induced by intestinal manipulation has been proposed as a pathophysiological factor in postoperative ileus (POI). We aimed to explore the relationship between peritoneal and colonic MC degranulation and gastrointestinal (GI) recovery following colectomy.
  
  
  METHODS
  Patients undergoing elective laparoscopic cholecystectomy (using a laparoscope and small abdominal incisions, n = 14), and elective laparoscopic (n = 32) or open partial colectomy (through a large abdominal incision, n = 10) were studied. MC protease tryptase and chymase were studied in peritoneal fluid at the beginning, middle, and end of each surgical intervention. Density of MCs in colectomy samples were examined and oro-caecal transit time by breath test, GI function recovery by clinical composite endpoint GI-2 and association between MC proteases and clinical recovery.
  
  
  RESULTS
  Open and laparoscopic colectomy caused greater peritoneal release of tryptase and chymase (323.0 ng/mL [IQR: 53.05-381.4] and 118.6 ng/mL [IQR: 53.60-240.3]), than cholecystectomy (41.64 ng/mL [IQR: 11.17-90.93]) at the end of the surgical intervention. However, there were no differences between laparoscopic and open colectomy. Increased peritoneal protease release during surgery was observed in patients who developed POI after colectomy.
  
  
  CONCLUSIONS
  Colorectal surgery causes protease release from peritoneal MCs. Protease release does not differ between both types of colectomy (laparoscopy vs laparotomy). However, MC activation is increased in colectomy patients developing POI. Therefore, degranulation of peritoneal MCs as a factor contributing to human POI after colectomy might be considered in future studies as a target to avoid POI.
authors: Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: S
authors: S
authors: Berdún
authors: Department of Surgery, Consorci Sanitari del Maresme (CSdM) - Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: E
authors: E
authors: Bombuy
authors: Department of Surgery, Consorci Sanitari del Maresme (CSdM) - Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: O
authors: O
authors: Estrada
authors: Department of Surgery, Consorci Sanitari del Maresme (CSdM) - Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: E
authors: E
authors: Mans
authors: Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.
authors: J
authors: J
authors: Rychter
authors: Department of Surgery, Consorci Sanitari del Maresme (CSdM) - Hospital de Mataró, Universitat Autònoma de Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.
authors: P
authors: P
authors: Clavé
authors: Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain.
authors: P
authors: P
authors: Vergara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000201:enzymology; D015550:Cell Degranulation; D017081:Cholecystectomy, Laparoscopic; D053818:Chymases / Q000378:metabolism*; D015331:Cohort Studies; D003082:Colectomy; D005260:Female; D006801:Humans; D045823:Ileus / Q000201:enzymology* / Q000276:immunology; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008407:Mast Cells / Q000276:immunology / Q000378:metabolism*; D008875:Middle Aged; D010537:Peritoneum / Q000166:cytology; D011183:Postoperative Complications / Q000201:enzymology* / Q000276:immunology; D011446:Prospective Studies; D020127:Recovery of Function; D053802:Tryptases / Q000378:metabolism*
chemical_list: D053818:Chymases; D053802:Tryptases
keywords: clinical recovery; intestinal surgery; mast cells; postoperative ileus