PATHOPHYSIOLOGICAL RESPONSE OF CYTOKINES AND VASOACTIVE AGENTS IN PATIENTS UNDERGOING TOTAL GASTRECTOMY

Objective: To investigate the involvement of vasoactive agents, endoth elin (ET)-1, and atrial natriuretic peptide (ANP), and the responses o f cytokines in patients undergoing total gastrectomy. Design: Prospect ive study. Setting: University hospital, Japan. Subjects: 20 patients with advanced gastric cancer who had undergone total gastrectomy with lymph node dissection. Interventions: Serum or plasma samples collecte d on the day before the operation, at the time of skin closure, and on postoperative days 1, 3, 5, and 7. Main outcome measures: Concentrati ons of acute phase reactants, cytokines (interleukin (IL)-1, tumour ne crosis factor (TNF) and interleukin (IL)-6), and vasoactive agents (ET -1 and ANP). Results: There were significant increases in concentratio ns of IL-6 and acute phase reactants postoperatively. ET-1 and ANP con centrations did not change significantly. Conclusion: There was no cor relation between concentrations of the vasoactive agents ET-1 and ANP, and those of acute phase reactants or cytokines in serum or plasma in patients undergoing total gastrectomy.