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[Postoperative changes in immunoreactive plasma endothelin concentrations].

K Ito1, N Goseki, M Endo

  • 1First Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan.

Nihon Geka Gakkai Zasshi
|November 1, 1991
PubMed
Summary
This summary is machine-generated.

Postoperative endothelin-1 (ET-1) levels significantly increased after esophagectomy but not gastrectomy, correlating with surgical stress and hemorrhage. This suggests ET-1 may indicate surgical trauma.

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Area of Science:

  • Cardiovascular Physiology
  • Surgical Endocrinology

Background:

  • Endothelin-1 (ET-1) is a potent vasoconstrictor with implications in cardiovascular regulation.
  • Surgical procedures can induce significant physiological stress, potentially affecting vasoactive peptide levels.

Purpose of the Study:

  • To investigate postoperative changes in plasma endothelin-1 (ET-1) concentrations.
  • To compare ET-1 level alterations between subtotal esophagectomy and total gastrectomy.
  • To explore correlations between ET-1 changes, intraoperative hemorrhage, atrial-natriuretic-peptide (ANP), and blood pressure.

Main Methods:

  • Radioimmunoassay was used to measure plasma ET-1 concentrations in two patient groups.
  • Group 1 (EC-group): 10 patients underwent subtotal esophagectomy (thoracotomy and celiotomy).
  • Group 2 (GC-group): 10 patients underwent total gastrectomy (celiotomy only).
  • Measurements were taken preoperatively and postoperatively, with intraoperative ANP and blood pressure also monitored.

Main Results:

  • Plasma ET-1 concentrations significantly increased postoperatively in the esophagectomy group (p < 0.01).
  • No significant change in plasma ET-1 was observed in the gastrectomy group.
  • A positive correlation was found between increased ET-1 and intraoperative hemorrhage (p < 0.05).
  • In the esophagectomy group, ET-1 correlated with changes in ANP (p < 0.05).
  • No correlation between ET-1 and blood pressure was detected.

Conclusions:

  • Subtotal esophagectomy leads to a significant increase in plasma ET-1, likely due to endothelial cell injury.
  • The observed increase in ET-1 may stimulate ANP secretion.
  • Plasma ET-1 concentration could serve as a reliable biomarker for surgical stress.