Effects of analgesic and surgical modality on immune response in colorectal cancer surgery.


Journal

Surgical oncology
ISSN: 1879-3320
Titre abrégé: Surg Oncol
Pays: Netherlands
ID NLM: 9208188

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 22 09 2020
revised: 10 04 2021
accepted: 04 05 2021
pubmed: 17 5 2021
medline: 18 1 2022
entrez: 16 5 2021
Statut: ppublish

Résumé

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. 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. More IL-10 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.

Sections du résumé

BACKGROUND AND OBJECTIVE 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 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 RESULTS
More IL-10
CONCLUSIONS 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.

Identifiants

pubmed: 33992897
pii: S0960-7404(21)00091-8
doi: 10.1016/j.suronc.2021.101602
pii:
doi:

Substances chimiques

Analgesics 0

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

101602

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Mohammed Faisal (M)

Department of Surgery, Surgical Oncology Unit, Faculty of Medicine, Suez Canal University, Egypt; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Christopher Niels Schäfer (CN)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Anesthesia, Operation and Intensive Care, Norrlands University Hospital, Umeå, Sweden.

Pär Myrelid (P)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Surgery, Linköping University, Linköping, Sweden.

Martin E Winberg (ME)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Johan D Söderholm (JD)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Surgery, Linköping University, Linköping, Sweden.

Åsa V Keita (ÅV)

Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden. Electronic address: asa.keita@liu.se.

Christina Eintrei (C)

Department of Anesthesiology and Intensive Care, Linköping University Hospital, Linköping, Sweden.

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Classifications MeSH