Effects of analgesic and surgical modality on immune response in colorectal cancer surgery
| Autor: | Åsa V. Keita, Christina Eintrei, Christopher Niels Schäfer, Martin E. Winberg, Pär Myrelid, Mohammed Faisal, Johan D. Söderholm |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Laparoscopic surgery Adult Male medicine.medical_specialty Surgical stress Colorectal cancer medicine.medical_treatment Analgesic Inflammation Malignancy Gastroenterology 03 medical and health sciences 0302 clinical medicine Immune system Internal medicine medicine Humans Prospective Studies Aged Aged 80 and over Analgesics business.industry Immunity Length of Stay Middle Aged medicine.disease Prognosis Analgesia Epidural 030104 developmental biology Oncology 030220 oncology & carcinogenesis Surgery Tumor necrosis factor alpha Administration Intravenous Female Laparoscopy medicine.symptom business Colorectal Neoplasms Colorectal Surgery Follow-Up Studies |
| Zdroj: | Surgical oncology. 38 |
| ISSN: | 1879-3320 |
| Popis: | Background and objective Different surgical methods, anesthesia, and analgesia are known to modify the surgical stress response, especially in patients with malignancy. We compared the impact of patient-controlled intravenous (PCA) versus epidural analgesia (EDA) on tumor-related mucosal immune response in patients undergoing open or laparoscopic surgery for colorectal cancer. Methods In a University Hospital subgroup (n = 43) of a larger cohort (n = 235) of patients undergoing open or laparoscopic surgery for colorectal carcinoma randomized to PCA or EDA, colorectal tissues were stained for interleukin-10 (IL-10), tumor necrosis factor (TNF), and mast cell tryptase and then examined by immunofluorescence microscopy. Results More IL-10+-cells were found in patients undergoing open compared to laparoscopic surgery in the PCA (P Conclusions The surgical method, rather than type of analgesia, may have higher impact on peri-operative inflammation. Laparoscopic surgery when combined with EDA for colorectal cancer caused a decrease in the TNF and IL-10 expression and mast cells. EDA seems to have an anti-inflammatory effect on cancer-related inflammation during open surgery. |
| Databáze: | OpenAIRE |
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