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GASTROİNTESTİNAL CERRAHİ SONRASI SİSTEMİK SİTOKİN-AKUT FAZ PROTEİN YANITI ÜZERİNDE SİKLOOKSİJENAZ İNHİBİSYONUNUN ETKİSİ

The Effect of Cyclo-oxygenase Inhibition on Systemic Cytokine-Acute Phase Protein Response After Gastrointestinal Surgery

Journal Name:

  • İnönü Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objectives: Surgical operations have been shown to cause a variety of changes in cytokines and acute phase proteins. These changes can be markedly attenuated or prevented by cyclo-oxygenase inhibition. Therefore the authors assessed the effect of piroxicam treatment, having the contradictory results regarding this subject, on cytokine and acute phase protein changes after surgery. Material and methods: The systemic cytokine and acute phase protein responses to major gastrointestinal surgery were studied in 24 patients undergoing elective gastric or rectal surgery. The patients were divided into two groups. Both groups had 12 patients and consisted of six patients undergoing subtotal distal gastrectomy and six patients undergoing low anterior resection. Piroxicam (10 mg, IM), a cyclo-oxygenase inhibitor, was administered to group II patients, but not to group I patients, 12 hour before surgery and 1 and 12 hours after surgery. Blood samples were collected 8 hour before surgery and one and five days after surgery for interleukin-6, tumor necrosis factor-a, C-reactive protein and fibrinogen determinations.a levels in fifth postoperative day were significantly lower (p<0.05) than those in first postoperative day in group II. In contrast, decreased levels were not obtained in group I patients. Conclusion: Piroxicam treatment in the perioperative course is able to reduce cytokine and acute phase protein responses. Therefore, piroxicam may be useful in decreasing the stress response regarding cytokines and acute phase proteins in patients undergoing major gastrointestinal surgery.
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Abstract (Original Language): 
Amaç: Cerrahi girişimler sitokin ve akut faz protein yanıtına sebebiyet verirler. Bu yanıt siklooksijenaz inhibisyonuyla önlenebilir. Bu çalışmada cerrahi girişim sonrası sitokin ve akut faz protein yanıtı üzerinde, bu konuyla ilgili çelişkili sonuçlara sahip olan Piroxicam tedavisinin etkin/i/iği incelendi. Materyal ve Metot: Elektif major gastrik veya rektum cerrahisine maruz kalan 24 hastada sistemik sitokin ve akut faz protein yanıtı incelendi. Hastalar 2 gruba ayrıldı. Her 2 grup 12 hastadan ibaret olup, 6' sına subtotal distal gastrektomi, 6' sına ise aşağı anterior rezeksiyon yapıldı. Bir siklooksijenaz inhibitörü olan Piroxicam (10 mg, intramuskuler) Grup I hastalara cerrahiden 12 saat önce ve 1 ile 12 saat sonra olmak üzere toplam 30 mg uygulandı. Grup II hastalara ise Piroxicam uygulanmadı. Cerrahi girişimden 8 saat önce ve 1 ile 5 gün sonra Interleukin-6, Tümör nekrozis faktör alfa, C-reaktif protein ve fibrinojenin serum seviyelerini ölçmek için kan örnekleri alındı. Bulgular: Grup I hastalarda Interleukin-6, Tümör nekrozis faktör alfa, C-reaktif protein ve fibrinojenin postoperatif 5. günkü seviyeleri postoperatif 1. gündeki değerlere göre önemli derecede düşmüştü (p<0.05). Bu farklılıklar Grup II hastalarda görülmedi. Sonuç: Peroperatif dönemdeki Piroxicam tedavisi sitokin ve akut faz protein yanıtını azaltabilir. Bu nedenle Piroxicam tedavisi major gastrointestinal cerrahi girişime maruz kalan hastalarda sitokin ve akut faz protein yanıtını azaltmada faydalı olabilir.
FULL TEXT (PDF): 
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  • 1
24-29
  • Turkish

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