Neutrophil adhesion molecules in colorectal surgery: Effect of filgrastim given perioperatively

Objective: To assess whether the postoperative expression of neutrophil adh esion molecules CD11b/CD18 (Mac-1) and CD62L (L-selectin) would differ in p eripheral blood, peritoneal fluid and wound fluid in patients operated on f or colorectal conditions, and to analyse the effect of perioperative filgra stim on their expression. Design: Prospective randomised double-blind placebo-controlled clinical stu dy. Setting: University hospital, Finland Subjects: Thirty consecutive patients undergoing elective colorectal. operations (15 in each group). Interventions: The patients were prospectively randomised to receive either filgrastim or placebo. Expression of neutrophil adhesion molecules was mea sured 48 hours postoperatively in peripheral blood, peritoneal fluid, and w ound fluid by flow cytometry. Results: Postoperative neutrophil CD11b/CD18 expression was higher in both wound fluid and peritoneal fluid than in peripheral blood in the placebo gr oup. Simultaneously, the expression of neutrophil CD62L was higher in perip heral blood than in peritoneal fluid or wound fluid in both groups. Filgras tim caused increased postoperative expression of neutrophil CD11b/CD18 in p eripheral blood but not in peritoneal fluid or wound fluid. Conclusions: Postoperative expression of neutrophil adhesion molecules diff ers at the local operation site from that in peripheral blood. Filgrastim i ncreases only blood neutrophil CD11b/CD18 expression.