scholarly journals Alterations of plasma glutamine and surgical stress in gastric cancer surgery

2019 ◽  
Author(s):  
Tsutomu Hayashi ◽  
Toru Aoyama ◽  
Hiroshi Yamamoto ◽  
Takanobu Yamada ◽  
Tsutomu Sato ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Interleukin 6 ◽  
Surgical Stress ◽  
Major Surgery ◽  
Open Approach ◽  
Glutamine Concentration ◽  
Eligibility Criteria ◽  
Glutamine Level ◽  
Plasma Glutamine Level ◽  
Negative Clinical Outcome

Abstract Background: The plasma glutamine levels are known to decrease after major surgery, which is related to a negative clinical outcome. However, the influence of surgical stress on the decrease in the plasma glutamine concentration is unclear. The aim of this study was to evaluate the change in glutamine in relation to the types of gastrectomy and approaches as well as the amount of surgical stress evaluated by serum interleukin-6(IL-6) as an objective indicator. Methods: This was a prospective observational study. The eligibility criteria were (1) gastric adenocarcinoma of the stomach confirmed by pathology and (2) patients scheduled to receive gastrectomy with lymphadenectomy for gastric cancer. Blood samples were taken at 7 AM on the day of surgery and at 12 h after surgery to measure the plasma glutamine and interleukin-6 (IL-6) levels. Results: Between May 2011 and December 2011, 81 consecutive patients were enrolled in this study. The plasma glutamine level was significantly decreased in all patients, regardless of distal or total gastrectomy and laparoscopic or open surgery. No significant differences were observed in the IL-6 level between total and distal gastrectomy patients or between patients treated via a laparoscopic or open approach. Decreases in the plasma glutamine level were positively correlated with the logarithmically transformed-plasma IL-6 (logIL6) (r =0.471, p<0.001) overall. Conclusions: Decreases in the glutamine concentration depended on the amount of surgical stress. When conducting a clinical trial to evaluate glutamine administration, personalized adjustment may be key to avoiding glutamine depletion in response to surgical stress.

scholarly journals Alterations of plasma glutamine and surgical stress in gastric cancer surgery.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 176-176
Author(s):  
Tsutomu Hayashi ◽  
Toru Aoyama ◽  
Hiroshi Yamamoto ◽  
Takanobu Yamada ◽  
Tsutomu Sato ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Interleukin 6 ◽  
Surgical Stress ◽  
Major Surgery ◽  
Open Approach ◽  
Glutamine Concentration ◽  
Eligibility Criteria ◽  
Glutamine Level ◽  
Plasma Glutamine Level ◽  
Negative Clinical Outcome

176 Background: The plasma glutamine levels are known to decrease after major surgery, which is related to a negative clinical outcome. However, the influence of surgical stress on the decrease in the plasma glutamine concentration is unclear. The aim of this study was to evaluate the change in glutamine in relation to the types of gastrectomy and approaches as well as the amount of surgical stress evaluated by serum interleukin-6(IL-6) as an objective indicator. Methods: This was a prospective observational study. The eligibility criteria were (1) gastric adenocarcinoma of the stomach confirmed by pathology and (2) patients scheduled to receive gastrectomy with D1 or D2 lymphadenectomy for gastric cancer. Blood samples were taken at 7 AM on the day of surgery and at 12 h after surgery to measure the plasma glutamine and interleukin-6 (IL-6) levels. Results: Between May 2011 and December 2011, 81 consecutive patients were enrolled in this study. The plasma glutamine level was significantly decreased in all patients, regardless of distal or total gastrectomy and laparoscopic or open surgery. No significant differences were observed in the IL-6 level between total and distal gastrectomy patients or between patients treated via a laparoscopic or open approach. Decreases in the plasma glutamine level were positively correlated with the logarithmically transformed-plasma IL-6 (logIL6) (r = 0.471, p < 0.001) overall. Conclusions: Decreases in the glutamine concentration depended on the amount of surgical stress. When conducting a clinical trial to evaluate glutamine administration, personalized adjustment may be key to avoiding glutamine depletion in response to surgical stress.

EFFECTS OF GENERAL ANAESTHESIA AND SEVERITY OF SURGICAL STRESS ON SERUM LH AND TESTOSTERONE IN MALES

1975 ◽  
Vol 78 (2) ◽  
pp. 258-269 ◽  
Author(s):  
A. Nakashima ◽  
K. Koshiyama ◽  
T. Uozumi ◽  
Y. Monden ◽  
Y. Hamanaka ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Surgical Stress ◽  
Fiberoptic Bronchoscopy ◽  
Serum Testosterone ◽  
Major Surgery ◽  
Succinylcholine Chloride ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Rate Of Increase ◽  
Male Patients

ABSTRACT Significantly decreased levels of serum testosterone from the pre-anaesthesia level were found during and up to 7 days following major surgery under general anaesthesia (nitrous oxide, oxygen and halothane following induction with thiopental and succinylcholine chloride) in 18 male patients. On the other hand, in the same patients, the serum luteinizing hormone (LH) increased significantly from the pre-anaesthesia level 30 min and 1 h after the beginning of anaesthesia. A slight increase in LH level was also noted on the 7th post-operative day. The determinations of serum testosterone and LH in fiberoptic bronchoscopy under the same general anaesthesia as that used in surgery or local anaesthesia in 26 male patients, revealed that the change in the serum LH during and following surgery seemed to be mainly induced by the general anaesthesia and that the rate of decrease in the serum testosterone may be related to the severity of surgical stress including the anaesthesia. The rate of increase in serum testosterone following the injection of gonadotrophin in 20 males on the 6th post-operative day was similar to that in 10 pre-operative males. The effects of pulmonary lobectomy on serum testosterone and urinary steroids were also studied in 6 males under adrenal suppression with dexamethasone. On the 6th post-operative day, the urinary aetiocholanolone plus androsterone and serum testosterone were found to be half the level of those on the pre-operative day, while the urinary 5β-pregnane-3α,17α,20α-triol remained unchanged. These observations in human are not inconsistent with the report of Tcholakian & Eik-Nes (1971) in dogs namely that a shift in androgen biosynthetic pathway is present in the testis under surgical stress.

scholarly journals Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Martin Hübner ◽  
Styliani Mantziari ◽  
Nicolas Demartines ◽  
François Pralong ◽  
Pauline Coti-Bertrand ◽  
...  
Keyword(s):  
Stress Response ◽  
Pilot Study ◽  
Clinical Outcomes ◽  
Surgical Stress ◽  
Major Surgery ◽  
Surgical Trauma ◽  
Once Daily ◽  
Reactive Protein ◽  
Estimated Blood Loss ◽  
Postoperative Stress

Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response.Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay.Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperativelyversus33.8±5.3 g/L at day 1,P<0.001). Alb Δ min was correlated with operation length (Pearsonρ=0.470,P<0.001), estimated blood loss (ρ=0.605,P<0.001), and maximal CRP values (ρ=0.391,P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4versus6.1±5.2,P=0.005) and a longer hospital stay (ρ=0.285,P<0.020).Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.

Altered Fibrinolysis during and after Surgery

2021 ◽  
Author(s):  
Maria J. Colomina ◽  
Esther Méndez ◽  
Antoni Sabate
Keyword(s):  
Surgical Stress ◽  
Point Of Care ◽  
Vena Cava ◽  
Coagulation Factors ◽  
Major Surgery ◽  
Fibrinogen Concentration ◽  
Tissue Destruction ◽  
Inflammatory Reactions ◽  
Hematological Disorders ◽  
Number Of Patients

AbstractMajor surgery induces hemostatic changes related to surgical stress, tissue destruction, and inflammatory reactions. These changes involve a shift of volume from extravascular space to intravascular and interstitial spaces, a “physiologic” hemodilution of coagulation proteins, and an increase of plasmatic fibrinogen concentration and platelets. Increases in fibrinogen and platelets together with a simultaneous dilution of pro- and anticoagulant factors and development of a hypofibrinolytic status result in a postoperative hypercoagulable state. This profile is accentuated in more extensive surgery, but the balance can shift toward hemorrhagic tendency in specific types of surgeries, for example, in prolonged cardiopulmonary bypass or in patients with comorbidities, especially liver diseases, sepsis, and hematological disorders. Also, acquired coagulopathy can develop in patients with trauma, during obstetric complications, and during major surgery as a result of excessive blood loss and subsequent consumption of coagulation factors as well as hemodilution. In addition, an increasing number of patients receive anticoagulants and antiplatelet drugs preoperatively that might influence the response to surgical hemostasis. This review focuses on those situations that may change normal hemostasis and coagulation during surgery, producing both hyperfibrinolysis and hypofibrinolysis, such as overcorrection with coagulation factors, bleeding and hyperfibrinolysis that may occur with extracorporeal circulation and high aortic-portal-vena cava clamps, and hyperfibrinolysis related to severe maintained hemodynamic disturbances. We also evaluate the role of tranexamic acid for prophylaxis and treatment in different surgical settings, and finally the value of point-of-care testing in the operating room is commented with regard to investigation of fibrinolysis.

A phase II study of perioperative capecitabine plus oxaliplatin for clinical SS/SE N1-3 M0 gastric cancer (OGSG1601).

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 203-203
Author(s):  
Atsushi Yasuda ◽  
Jin Matsuyama ◽  
Tetsuji Terazawa ◽  
Masahiro Goto ◽  
Ryohei Kawabata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Statistical Significance ◽  
Dose Intensity ◽  
Residual Tumor ◽  
Pathological Response ◽  
R0 Resection ◽  
Eligibility Criteria ◽  
English Edition ◽  
D2 Gastrectomy ◽  
Japanese Classification

203 Background: D2 gastrectomy followed by adjuvant S-1 is one of the standard therapy for the patients (pts) with stage III gastric cancer (GC) in Japan; however, the outcome is not satisfactory. We examined the efficacy of perioperative capecitabine and oxaliplatin (CapeOx) in pts with clinical SS/SE N1-3 M0 GC. Methods: The eligibility criteria included histopathologically confirmed clinical T3(SS)/T4a(SE) N1-3 M0 GC according to the Japanese Classification of GC (JCGC; 3rd English Edition). Three cycles of neoadjuvant CapeOx (NAC; capecitabine, 2,000 mg/m2 for 14 days; oxaliplatin, 130 mg/m2 on day 1, every 3 weeks) were administered, followed by five cycles of adjuvant CapeOx after D2 gastrectomy. The primary endpoint was the pathological response rate (pRR) according to JCGC ( ≥Grade 1b). Results: Thirty-seven pts were enrolled from April 2016 to May 2017, and fully evaluated for efficacy and toxicity. Thirty-three pts (89.2%) completed the planned three cycles of NAC and underwent gastrectomy, with an R0 resection rate of 78.4% (n = 29) and a pRR of 54.1% (n = 20, p = .058; 90% confidence interval [CI], 39.4–68.2) were demonstrated. The relative dose intensity (RDI) of capecitabine and oxaliplatin were 90.5% and 91.9%, respectively. Among 27 pts who initiated AC, 21 (63.6%) completed the treatment, and the RDI of capecitabine and oxaliplatin were 80.9% and 65.1%, respectively. Grade 3–4 toxicities during NAC included neutropenia (8%), thrombocytopenia (8%), and anorexia (8%) and during AC included neutropenia (37%), diarrhea (4%), and anorexia (4%), but no treatment-related death was reported. The overall survival (OS) rate and relapse free survival (RFS) rate at 3 years was 83.8% (95% CI, 72.7-96.5%) and 73.0% (95% CI, 60.0-88.8%), respectively. Subgroup analyses according to residual tumor after surgery (R status) showed a 3-year OS and RFS rate of 86.2% (95% CI, 74.5-99.7%) and 75.7% (95% CI, 63.0-90.8%) for R0. Conclusions: Perioperative CapeOx showed good feasibility and favorable prognosis with sufficient pathological response, although statistical significance at .058 did not reach the commonly accepted cutoff of .05. The data obtained using this novel approach warrant further investigations. Clinical trial information: 000021641.

Interleukin 6 induces M2 macrophage differentiation by STAT3 activation that correlates with gastric cancer progression

2017 ◽  
Vol 66 (12) ◽  
pp. 1597-1608 ◽  
Author(s):  
Xiao-Long Fu ◽  
Wei Duan ◽  
Chong-Yu Su ◽  
Fang-Yuan Mao ◽  
Yi-Ping Lv ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Progression ◽  
Interleukin 6 ◽  
M2 Macrophage ◽  
Macrophage Differentiation ◽  
Gastric Cancer Progression

Interleukin-6 upregulation following tumour-mesothelial contact - a role in peritoneal metastasis in gastric cancer.

2007 ◽  
Vol 33 (9) ◽  
pp. 1091-1091
Author(s):  
S REKHRAJ ◽  
S PRABHUDESAI ◽  
G ROBERTS ◽  
A DARZI ◽  
P ZIPRIN
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Metastasis ◽  
Interleukin 6

scholarly journals Surgical stress detection in human blood plasma by DSC

2020 ◽  
Vol 142 (2) ◽  
pp. 783-788 ◽  
Author(s):  
Andrea Ferencz ◽  
Dénes Lőrinczy
Keyword(s):  
Blood Loss ◽  
Blood Plasma ◽  
Surgical Intervention ◽  
Surgical Stress ◽  
Venous Blood ◽  
Operation Time ◽  
Major Surgery ◽  
Human Blood Plasma ◽  
Thermal Transitions ◽  
Surgical Interventions

Abstract It is a well-known fact that the extension of the surgical intervention influences both the success and time of the patient’s recovery, the degree of the blood loss, i.e., overall the patients’ surgical burden. Disease itself determines extent of surgical procedure (minor, intermediate or major surgery), which affects the risk and frequency of complications. Previous works have contributed to the validation of differential scanning calorimetry (DSC) as a potential non-invasive tool for diagnosing and monitoring several illnesses. Hence, the main goal of this study was to measure the effect of each surgical intervention on its own to blood plasma composition. Peripheral venous blood samples were collected from patients who underwent minor (n = 8), intermediate (n = 9) and major surgical interventions (n = 7). According our DSC data of blood plasma components, from the thermodynamic parameters, namely from the thermal transitions (Tm1–Tm8) to calorimetric enthalpy (ΔHcal) in proportion corresponded to the size of surgical interventions (duration of operation time, length of incision, surgical intraoperative stress, blood loss, etc.). This examination has shown that intraoperative stress during any surgical intervention affects the composition of plasma proteins, which should be always considered in the evaluation of DSC results in any surgical study.

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