eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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4/2022
vol. 17
 
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General surgery
abstract:
Original paper

The importance of inflammatory markers in detection of complications in patients with gastric cancer undergoing the Enhanced Recovery After Surgery (ERAS) protocol: a prospective cohort study

Alpen Yahya Gumusoglu
1
,
Hamit Ahmet Kabuli
1
,
Murat Cikot
1
,
Nilgun Isiksacan
2
,
Pinar Kasapoglu
2
,
Ertug Can Cayırcı
1
,
Sinan Binboga
1
,
Mehmet Karabulut
1
,
Halil Alis
3

  1. Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
  2. Department of Biochemistry, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
  3. Department of General Surgery, Faculty of Medicine, Istanbul Aydin University VM Medical Park Florya Hospital, Istanbul, Turkey
Videosurgery Miniinv 2022; 17 (4): 688–698
DOI: https://doi.org/10.5114/wiitm.2022.118799
Online publish date: 2022/08/15
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Introduction
Early diagnosis reduces mortality and morbidity rates in gastrointestinal system (GIS) anastomoses.

Aim
The aim of the present study was to investigate the importance of some substances that were used to detect major complications early in patients who were treated in line with the Enhanced Recovery After Surgery (ERAS) protocol for gastric cancer. Factors included in the study were interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), procalcitonin (PCT) and white blood cell (WBC).

Material and methods
A hundred and twenty patients who underwent laparoscopic subtotal or total gastrectomy for gastric cancer in accordance with the ERAS protocol between January 2018 and December 2019 were included in this prospective study. Blood values of IL-1β, TNF-α, CRP, PCT, and WBC on the third and fifth post-operative days (POD) were measured for diagnosing major complications.

Results
Major complications occurred in 12 (10%) patients. Third POD and fifth POD measurements of IL-1β, TNF-α, CRP, PCT were statistically significantly higher than those in the non-complicated group, whereas WBC was not. In addition, in the group with complications, statistically significant changes of the blood levels of IL-1β, TNF-α, CRP, and PCT between the 3rd and 5th days were detected (p = 0.008, p = 0.001, p = 0.004, p = 0.001 respectively).

Conclusions
IL-1β, TNF-α, CRP, and PCT can be used in the early detection of major complications in gastric cancer patients undergoing the ERAS protocol. Imaging methods should be used in patients with high levels of these inflammatory substances on the third and fifth POD.

keywords:

complication, gastric cancer, inflammatory markers, early diagnosis
  
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