Sex, Type of Surgery, and Surgical Site Infections Are Associated with Perioperative Cortisol in Colorectal Cancer Patients.
Mariusz G FleszarPaulina FortunaMarek ZawadzkiPaweł HodurekIwona Bednarz-MisaWojciech WitkiewiczMałgorzata Krzystek-KorpackaPublished in: Journal of clinical medicine (2021)
Excessive endocrine response to trauma negatively affects patients' well-being. Cortisol dynamics following robot-assisted colorectal surgery are unknown. We aimed at determining the impact of cancer pathology and surgery-related factors on baseline cortisol levels and analyzed its time-profile in colorectal cancer patients undergoing open or robot-assisted surgery. Cortisol levels were measured using liquid chromatography quadrupole time-of-flight mass spectrometry. Baseline cortisol was not associated with any patient- or disease-related factors. Post-surgery cortisol increased by 36% at 8 h and returned to baseline on postoperative day three. The cortisol time profile was significantly affected by surgery type, estimated blood loss, and length of surgery. Baseline-adjusted cortisol increase was greater in females at hour 8 and in both females and patients from open surgery group at hour 24. Solely in the open surgery group, cortisol dynamics paralleled changes in interleukin (IL)-1β, IL-10, IL-1ra, IL-7, IL-8 and tumor necrosis factor (TNF)-α but did not correlate with changes in IL-6 or interferon (IFN)-γ at any time-point. Cortisol co-examined with C-reactive protein was predictive of surgical site infections (SSI) with high accuracy. In conclusion, patient's sex and surgery invasiveness affect cortisol dynamics. Surgery-induced elevation can be reduced by minimally invasive robot-assisted procedures. Cortisol and C-reactive protein as SSI biomarkers might be of value in the evaluation of safety of early discharge of patients.
Keyphrases
- minimally invasive
- robot assisted
- coronary artery bypass
- end stage renal disease
- surgical site infection
- patients undergoing
- newly diagnosed
- ejection fraction
- chronic kidney disease
- prognostic factors
- dendritic cells
- blood pressure
- rheumatoid arthritis
- immune response
- cardiac surgery
- ms ms
- acute coronary syndrome
- patient reported outcomes
- systemic sclerosis
- systemic lupus erythematosus
- lymph node metastasis
- high resolution
- papillary thyroid
- atrial fibrillation
- drug induced
- weight loss
- disease activity