SERUM INTERLEUKIN-6, INTERLEUKIN-8, HEPATOCYTE GROWTH-FACTOR, AND NITRIC-OXIDE CHANGES DURING THORACIC-SURGERY

Thoracic surgery creates a different environment from abdominal surger y in respect to the surgical procedure with pulmonary collapse under u nilateral ventilation. Definitive evidence whether surgical trauma dur ing thoracotomy is involved in postoperative pulmonary infections has not been clearly demonstrated. The objectives of this study were to ev aluate the influence of surgical trauma during thoracotomy on postoper ative infections and to investigate the clinical significance of posto perative humoral mediators in pulmonary infections after surgery. We m easured serum interleukin-6 (IL-6), IL-8, hepatocyte growth factor (HG F), and nitric oxide (NO) levels in 27 patients undergoing thoracic su rgery; the measurements were before and during thoracotomy, 60 minutes after reinflation, and after surgery. The patients were divided into three groups: lobectomy patients (group A), and esophagectomy patients without (group B) or with (group C) postoperative infections. The ser um IL-6 and IL-8 levels in group C were markedly elevated 60 minutes a fter reinflation and were significantly higher than those in group A. The serum IL-8 levels during that period in group C were significantly higher than those in group B. The postoperative serum IL-6, IL-8, HGF , and NO levels were significantly higher in group C than in group B. Taken together, intraoperative hypercytokinemia, especially IL-8, foll owing the thoracic procedure and subsequent reinflation preceded the c linical onset of postoperative infections. Hence postoperative serum I L-6, IL-8, and HGF levels may be useful predictors of infection after esophagectomy.