Systemic and Local Inflammatory Mediator Response to Major Surgery
Author
Summary, in English
Major surgery evoked a cytokine response in the systemic circulation, which was enhanced by the presence of a cancer, in colorectal resections. The IL-6 response in colorectal surgery originated from the bowel and enhanced concentrations of IL-6 in tissue of colorectal cancers, emanating from an IL-6 expression in the malignant epithelium, might be the source. Open surgery for abdominal aortic aneurysm (AAA) repair induced higher IL-6 responses than transfemorally placement of endoluminal grafts (TPEG), lower peri-operative sigmoidal pH but equal down-regulation of the HLA-DR expression on monocytes. These findings suggest that tissue destruction influences the systemic IL-6 response in trauma, but not the down-regulation HLA-DR expression on monocytes.
Experimental colonic obstruction in rats implied a local inflammatory response and an increased break-down of collagen by matrix metalloproteinases in the colonic wall, leading to a decrease in collagen concentration, assessed as hydroxyproline concentration. Inhibition of MMPs in the early phase of anastomotic healing in the colon, resulted in increased breaking strength of the anastomoses in inhibitor-treated animals compared to controls, confirming a negative role of MMPs in this phase of colonic healing. The knowledge on cytokine response to surgical trauma and interactions with the healing process needs to be expanded by studies on local events in tissue. The information on collagenase up-regulation in the local inflammatory response in the colon and the results of MMP-inhibition in anastomotic healing are promising in the efforts to improve healing in colorectal surgery.
Department/s
Publishing year
2000
Language
English
Document type
Dissertation
Publisher
Department of Surgery, Malmö University Hospital, Lund University
Topic
- Surgery
Keywords
- orthopaedics
- Surgery
- traumatologi
- ortopedi
- Kirurgi
- traumatology
Status
Published
Research group
- Surgery
Supervisor
- [unknown] [unknown]
ISBN/ISSN/Other
- ISBN: 91-628-4355-9
- ISRN: LUMEDW/MESM-1078-SE
Defence date
29 November 2000
Defence time
10:15
Defence place
Dept of Surgery, Malmö University Hospital, Entrance 42, Lecture Hall, Ground floor
Opponent
- Ulf Haglund