- 作者：Hironori Tsujimoto ; MD ; PhD ; tsujihi@ndmc.ac.jp ; Risa Takahata ; MD ; Shinsuke Nomura ; MD ; Isao Kumano ; MD ; Yusuke Matsumoto ; MD ; Kazumichi Yoshida ; MD ; Shuichi Hiraki ; MD ; PhD ; Suefumi Aosasa ; MD ; PhD ; Satoshi Ono ; MD ; PhD ; Junji Yamamoto ; MD ; PhD ; Kazuo Hase ; MD ; PhD
- 关键词：Systemic inflammatory response syndrome ; Pneumonia ; Interleukin-6 ; Minimal invasive surgery
- 刊名：Journal of Surgical Research
- 出版年：2013
- 出版时间：15 June, 2013
- 年：2013
- 卷：182
- 期：2
- 页码：e61-e67
- 全文大小：617 K
Objective
Pulmonary complications after esophagectomy continue to be a significant cause of morbidity and mortality. Although several factors have been implicated to be associated with pulmonary complications after esophagectomy, the prediction of pulmonary complications remains a challenge. The purpose of this study was to evaluate the predictive value of cytokine levels in sera and pleural drainage fluid for pneumonia and hypo-oxygenations following esophagectomy.Methods
A total of 66 patients who underwent esophagectomy for esophageal cancer were retrospectively evaluated for preoperative status, surgical procedures, and postoperative systemic response and laboratory data up to postoperative day (POD) 7. Interleukin-6 (IL-6) and IL-8 levels were also examined in patient sera and pleural drainage fluid until POD?5.
Results
Eighteen patients (27.3 % ) had pneumonia following esophagectomy. Patients with pneumonia had significantly more frequent intraoperative blood transfusions, more frequent re-intubation, longer hospital stays, and higher hospital mortality than those without pulmonary complications. Patients with pneumonia had significantly higher levels of serum and pleural IL-6 immediately after surgery and on POD 1 than those without pneumonia. Univariate and multivariate analyses revealed higher pleural IL-6 levels were associated with postoperative minimum PaO2/FiO2 ratio.
Conclusions
The elevation of pleural IL-6 levels immediately after surgery and on POD 1 may predict the incidence of pneumonia and the levels of postoperative impaired oxygenation following esophagectomy.