■据报道,结直肠癌(CRC)的小剖腹手术可缩短术后肠梗阻(POI)和住院时间。白细胞介素-6(IL-6)在肠组织炎症中起作用,导致POI。这项研究调查了腹部伤口和IL-6水平对CRC手术患者POI的影响。
■43例CRC患者接受了肠切除术。术前和术后2、24和48小时收集血清样品,通过ELISA定量细胞因子。临床数据,包括从手术到首次排气的时间和术后住院时间,人口统计学和病理学数据,和常规血液检查,与腹部伤口长度和术后细胞因子增量(称为Δ)进行统计学比较。
■腹部伤口的长度与临床变量(手术时间的长度,第一次肠胃排气通过的时间,和术后住院时间)和细胞因子变量(IL-6(Δ2h),IL-8(Δ2h)和IL-10(Δ2h)。线性回归分析显示,腹部伤口长度显著影响手术时间,第一次肠胃排气通过的时间,术后住院时间(p<0.001)。腹部伤口的长度对IL-6(Δ2h)和IL-8(Δ2h)有显着影响(分别为p<0.001),但对IL-10(Δ2h)没有影响。IL-6(Δ2h),但不是IL-8(Δ2h),对首次肛门排气时间和住院时间有显著影响(分别为p=0.007,p=0.006)。微型开腹手术(伤口长度<7cm)导致手术时间明显缩短,第一次肠胃排气通过的时间,术后住院时间(分别为p=0.004,p=0.003,p=0.006)以及术后IL-6增加减少(Δ2h)(p=0.015)。小切口开腹前切除术显著影响手术时间,首次排气的时间,术后住院时间,和IL-6(Δ2h)。
■我们的研究首次报道了腹部伤口长度之间的复杂相互作用,IL-6血清水平,恢复第一次排气,术后住院时间。这些结果表明,较小的腹部伤口和较小的术后IL-6增量与更快的肛门排气通道恢复和更短的住院时间有关。
UNASSIGNED: A mini-laparotomy for colorectal cancer (CRC) has been reported to shorten postoperative ileus (POI) and hospital stay. Interleukin-6 (IL-6) plays a role in intestinal tissue inflammation, leading to POI. This study investigated the effects of abdominal wounds and IL-6 levels on POI in patients having CRC surgery.
UNASSIGNED: Forty-three patients with CRC underwent bowel resection. Serum samples were collected preoperatively and at 2, 24, and 48 h after surgery for cytokine quantification by ELISA. Clinical data, including time from surgery to first passage of flatus and postoperative hospital stay, demographic and pathological data, and routine blood tests, were compared statistically with abdominal wound length and the postoperative increments of cytokines (designated as Δ).
UNASSIGNED: The length of the abdominal wound showed a significant correlation with clinical variables (length of operation time, time of first flatus passage, and length of postoperative hospital stay) and cytokine variables (IL-6(Δ2 h), IL-8(Δ2 h) and IL-10(Δ2 h). Linear regression analysis showed that the abdominal wound length significantly influenced the operation time, time of first flatus passage, and length of postoperative hospital stay (p < 0.001). The length of the abdominal wound showed a significant influence on the IL-6(Δ2 h) and IL-8(Δ2 h) (p < 0.001, respectively) but no influence on IL-10(Δ2 h). IL-6(Δ2 h), but not IL-8(Δ2 h), significantly influenced the time to first flatus passage and length of hospital stay (p = 0.007, p = 0.006, respectively). The mini-laparotomy approach (wound length <7 cm) led to significantly shortened operation time, time of first flatus passage, length of postoperative stay (p = 0.004, p = 0.003, p = 0.006, respectively) as well as reduced postoperative increment of IL-6(Δ2 h) (p = 0.015). The mini-laparotomy for anterior resection surgery significantly influenced operation time, time of first passage of flatus, length of postoperative stay, and IL-6(Δ2 h).
UNASSIGNED: Our study is the first to report the complex interaction among the length of the abdominal wound, IL-6 serum level, recovery of the first passage of flatus, and postoperative hospital stay. These results suggest that smaller abdominal wounds and smaller postoperative IL-6 increments were associated with faster recovery of flatus passage and shorter hospital stays.