Skip to main content
SpringerLink
Log in

Cytokine response in peripheral blood indicates different pathophysiological mechanisms behind anastomotic leakage after low anterior resection: a pilot study

  • Original Article
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

Anastomotic leakage (AL) after rectosigmoid resection is a serious complication associated with high morbidity and mortality. This case–control pilot study investigated the changes in blood concentration of 10 different cytokines and 2 complement factors in relation to symptomatic AL after low anterior resection for rectosigmoid cancer.

Methods

Fifty patients scheduled for resection of rectosigmoid cancer had blood samples taken the day before surgery and on post-operative days 1, 3 and 5. Four patients with symptomatic AL were identified. Twenty-two age- and disease-matched patients constituted the control group. The concentration of 10 cytokines (granulocyte macrophage colony-stimulating factor, interferon-γ, interleukin-1β, interleukin-2, interleukin-4, interleukin-5, interleukin-6, interleukin-8, interleukin-10 and tumour necrosis factor-α) and 2 complement factors (mannan-binding lectin and membrane attack complex) were measured.

Results

The present study demonstrated that plasma concentration of interleukin-1β, interleukin-6, interleukin-8 and interleukin 10 within the first 5 post-operative days was increased in patients who developed early clinical AL, whereas there were no changes in patients with late-onset AL.

Conclusions

The demonstrated differences in the cytokine response in early and late AL may support the theory of different pathological mechanisms of AL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Sacchi M, Legge PD, Picozzi P et al (2007) Virtual ileostomy following TME and primary sphincter-saving reconstruction for rectal cancer. Hepatogastroenterology 54:1676–1678

    PubMed  Google Scholar 

  2. Matthiessen P, Strand I, Jansson K et al (2007) Is early detection of anastomotic leakage possible by intraperitoneal microdialysis and intraperitoneal cytokines after anterior resection of the rectum for cancer? Dis Colon Rectum 50:1918–1927

    Article  PubMed  Google Scholar 

  3. Rullier E, Laurent C, Garrelon JL et al (1998) Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85:355–358

    Article  PubMed  CAS  Google Scholar 

  4. Nesbakken A, Nygaard K, Lunde OC (2001) Outcome and late functional results after anastomotic leakage following mesorectal excision for rectal cancer. Br J Surg 88:400–404

    Article  PubMed  CAS  Google Scholar 

  5. Law WL, Chu KW (2004) Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann Surg 240:260–268

    Article  PubMed  PubMed Central  Google Scholar 

  6. den Dulk M, Noter SL, Hendriks ER et al (2009) Improved diagnosis and treatment of anastomotic leakage after colorectal surgery. Eur J Surg Oncol 35:420–426

    Article  Google Scholar 

  7. Matthiessen P, Henriksson M, Hallöök O et al (2007) Increase of serum c-reactive protein is an early indicator of subsequent symptomatic anastomotic leakage after anterior resection. Colorectal Dis 10:75–80

    PubMed  Google Scholar 

  8. Platt JJ, Ramanathan ML, Crosbie RA et al (2012) C-reactive protein as a predictor of postoperative infective complications after curative resection in patients with colorectal cancer. Ann Surg Oncol 19:4168–4177

    Article  PubMed  Google Scholar 

  9. Rahbari NN, Weitz J, Hohenberger W et al (2010) Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery 147:339–351

    Article  PubMed  Google Scholar 

  10. Haahr-Pedersen S, Bjerre M, Flyvbjerg A et al (2009) Level of complement activity predicts cardiac dysfunction after acute myocardial infarction treated with primary percutaneous coronary intervention. J Invasive Cardiol 21:13–19

    PubMed  Google Scholar 

  11. Fouda E, Nakeeb AE, Magdy A et al (2011) Early detection of anastomotic leakage after elective low anterior resection. J Gastrointest Surg 15:137–144

    Article  PubMed  Google Scholar 

  12. Cruickshank AM, Fraser WD, Burns HJ et al (1990) Response of serum interleukin-6 in patients undergoing elective surgery of varying severity. Clin Sci 79:161–165

    PubMed  CAS  Google Scholar 

  13. Pedersen ME, Qvist N, Bisgaard C et al (2009) Peritoneal microdialysis early diagnosis of anastomotic leakage after low anterior resection for rectosigmoid cancer. Scand J Surg 98:148–154

    Google Scholar 

  14. Wagner M, Zappa M, Maggiori L, Bretagnol F, Vilgrain V, Panis Y (2014) Can postoperative complications be predicted by a routine CT scan on day 5? A study of 78 laparoscopic colorectal resections. Tech Coloproctol 18:239–245

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Surgery, Odense University Hospital, 5000, Odense, Denmark

    M. B. Ellebæk, C. Fristrup & N. Qvist

  2. Department of Surgery, Svendborg Hospital, Svendborg, Denmark

    G. Baatrup

  3. Department of Anesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark

    J. Gjedsted

Authors
  1. M. B. Ellebæk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Baatrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Gjedsted
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Fristrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N. Qvist
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. B. Ellebæk.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ellebæk, M.B., Baatrup, G., Gjedsted, J. et al. Cytokine response in peripheral blood indicates different pathophysiological mechanisms behind anastomotic leakage after low anterior resection: a pilot study. Tech Coloproctol 18, 1067–1074 (2014). https://doi.org/10.1007/s10151-014-1204-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-014-1204-2

Keywords

Search

Navigation