Surgical stress response after colorectal resection

Area of Science:

• Surgical oncology
• Immunology
• Metabolic studies

Background:

• The human body's physiological response to surgery is linked to the degree of tissue damage incurred.
• Understanding these responses is crucial for optimizing patient recovery and outcomes in colorectal surgery.

Purpose of the Study:

• To prospectively map key physiological parameters over time following elective colorectal surgery.
• To compare these parameters between colon resection and rectum resection/amputation procedures.
• To identify potential biomarkers for surgical stress.

Main Methods:

• Prospective study including 18 patients undergoing elective colorectal surgery (9 colon resection, 9 rectum resection/amputation).
• Measurement of inflammation (IL-10, C-reactive protein, IL-6, IL-8), metabolism (glucose, cortisol, insulin), nutrition (albumin, prealbumin, TIBC), respiratory function (forced expiratory volume in 1 second), muscle strength (grip strength), and well-being (pain, fatigue, nausea).
• Analysis of parameters at baseline and various postoperative time points.

Main Results:

• Higher postoperative interleukin 10 (IL-10) levels observed in the rectum surgery group on postoperative days 0 and 3.
• Significant differences in albumin, prealbumin, and total iron-binding capacity (TIBC) between groups, with differences in albumin and TIBC persisting until postoperative day 7.
• No significant differences found for C-reactive protein, IL-6, IL-8, glucose, cortisol, insulin, pain, fatigue, nausea, grip strength, or forced expiratory volume in 1 second.
• No correlation identified between measured parameters and postoperative complications.

Conclusions:

• Postoperative levels of IL-10, albumin, prealbumin, and TIBC may serve as reliable indicators of surgical stress after colorectal surgery.
• These markers can potentially help quantify the physiological impact of different colorectal surgical procedures.