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Open AccessArticle

Distinct Chemokine Dynamics in Early Postoperative Period after Open and Robotic Colorectal Surgery

1
Department of Medical Biochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland
2
Department of Oncological Surgery, Regional Specialist Hospital, 51-124 Wroclaw, Poland
3
Infection Control Unit, Regional Specialist Hospital, 51-124 Wroclaw, Poland
4
Research and Development Centre at Regional Specialist Hospital, 51-124 Wroclaw, Poland
5
Laboratory of Medical Microbiology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(6), 879; https://doi.org/10.3390/jcm8060879
Received: 6 May 2019 / Revised: 29 May 2019 / Accepted: 17 June 2019 / Published: 19 June 2019
(This article belongs to the Special Issue Robotic Surgery)
Stress response to robot-assisted colorectal surgery is largely unknown. Therefore, we conducted a prospective comparative nonrandomized study evaluating the perioperative dynamics of chemokines: IL-8/CXCL8, MCP-1/CCL2, MIP-1α/CCL3, MIP-1β/CCL4, RANTES/CCL5, and eotaxin-1/CCL11 in 61 colorectal cancer patients following open colorectal surgery (OCS) or robot-assisted surgery (RACS) in reference to clinical data. Postoperative IL-8 and MCP-1 increase was reduced in RACS with a magnitude of blood loss, length of surgery, and concomitant up-regulation of IL-6 and TNFα as its independent predictors. RANTES at 8 h dropped in RACS and RANTES, and MIP1α/β at 24 h were more elevated in RACS than OCS. IL-8 and MCP-1 at 72 h remained higher in patients subsequently developing surgical site infections, in whom a 2.6- and 2.5-fold increase was observed. IL-8 up-regulation at 24 h in patients undergoing open procedure was predictive of anastomotic leak (AL; 94% accuracy). Changes in MCP-1 and RANTES were predictive of delayed restoration of bowel function. Chemokines behave differently depending on procedure. A robot-assisted approach may be beneficial in terms of chemokine dynamics by favoring Th1 immunity and attenuated angiogenic potential and postoperative ileus. Monitoring chemokine dynamics may prove useful for predicting adverse clinical events. Attenuated chemokine up-regulation results from less severe blood loss and diminished inflammatory response. View Full-Text
Keywords: surgical stress response; surgical site infection; Th1/Th2 balance; interleukin-8; monocyte chemoattractant protein-1 (MCP1); postoperative ileus; anastomotic leak; robotic surgery; minimally invasive surgery surgical stress response; surgical site infection; Th1/Th2 balance; interleukin-8; monocyte chemoattractant protein-1 (MCP1); postoperative ileus; anastomotic leak; robotic surgery; minimally invasive surgery
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Krzystek-Korpacka, M.; Zawadzki, M.; Lewandowska, P.; Szufnarowski, K.; Bednarz-Misa, I.; Jacyna, K.; Witkiewicz, W.; Gamian, A. Distinct Chemokine Dynamics in Early Postoperative Period after Open and Robotic Colorectal Surgery. J. Clin. Med. 2019, 8, 879.

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