Is early detection of anastomotic leakage possible by intraperitoneal microdialysis and intraperitoneal cytokines after anterior resection of the rectum for cancer?

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Matthiessen, Peter,1957-Linköpings universitet,Kirurgi,Hälsouniversitetet (author)

Is early detection of anastomotic leakage possible by intraperitoneal microdialysis and intraperitoneal cytokines after anterior resection of the rectum for cancer?

Article/chapterEnglish2007

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Philadelphia :Lippincott Williams & Wilkins,2007
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LIBRIS-ID:oai:DiVA.org:oru-11572
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-11572URI
https://doi.org/10.1007/s10350-007-9023-4DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-8167URI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-52066URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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On the day of the defence data the status of this article was: Submitted.
PURPOSE: This prospective study assessed methods of detecting intraperitoneal ischemia and inflammatory response in patients with and without postoperative complications after anterior resection of the rectum. METHODS: In 23 patients operated on with anterior resection of the rectum for rectal carcinoma, intraperitoneal lactate, pyruvate, and glucose levels were monitored postoperatively for six days by using microdialysis with catheters applied in two locations: intraperitoneally near the anastomosis, and in the central abdominal cavity. A reference catheter was placed subcutaneously in the pectoral region. Cytokines, interleukin (IL)-6, IL-10, and tumor necrosis factor (TNF)-alpha, were measured in intraperitoneal fluid by means of a pelvic drain for two postoperative days. RESULTS: The intraperitoneal lactate/pyruvate ratio near the anastomosis was higher on postoperative Day 5 (P = 0.029) and Day 6 (P = 0.009) in patients with clinical anastomotic leakage (n = 7) compared with patients without leakage (n = 16). The intraperitoneal levels of IL-6 (P = 0.002; P = 0.012, respectively) and IL-10 (P = 0.002; P = 0.041, respectively) were higher on postoperative Days 1 and 2 in the leakage group, and TNF-alpha was higher in the leakage group on Day 1 (P = 0.011). In-hospital clinical anastomotic leakage was diagnosed on median Day 6, and leakage after hospital discharge on median Day 20. CONCLUSIONS: The intraperitoneal lactate/pyruvate ratio and cytokines, IL-6, IL-10, and TNF-alpha, were increased in patients who developed symptomatic anastomotic leakage before clinical symptoms were evident.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICINE
MEDICIN
Surgery
Kirurgi
Medicine
medicin

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Strand, IdaDepartment of Surgery, Örebro University Hospital, Örebro, Sweden (author)
Jansson, KjellDepartment of Surgery, Örebro University Hospital, Örebro, Sweden (author)
Törnquist, CathrineDepartment of Surgery, Örebro University Hospital, Örebro, Sweden (author)
Andersson, MagnusDepartment of Surgery, Örebro University Hospital, Örebro, Sweden (author)
Rutegård, JörgenUmeå universitet,Kirurgi,Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:umu)jaru0001 (author)
Norgren, LarsÖrebro universitet,Hälsoakademin,Department of Surgery, Örebro University Hospital, Örebro, Sweden(Swepub:oru)lsnn (author)
Linköpings universitetKirurgi (creator_code:org_t)

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In:Diseases of the Colon & RectumPhiladelphia : Lippincott Williams & Wilkins50:11, s. 1918-19270012-37061530-0358

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By the author/editor: Matthiessen, Pet ...; Strand, Ida; Jansson, Kjell; Törnquist, Cathr ...; Andersson, Magnu ...; Rutegård, Jörgen; show more...; Norgren, Lars; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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By the university: Örebro University; Umeå University; Linköping University

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