Perioperative Blood Adiponectin Dynamics and Systemic Infflamatory Response After Major Colorectal Surgery

Summary

Surgical stress after major abdominal surgery in perioperative period causes neuroendocrine, metabolic and imunologic changes in organism with production of proinfflamatory citokines and results with appearance of systemic infflammmatory response syndrome (SIRS). Dysregulated and overrated SIRS in early postoperative period can lead to complications with additional comorbidities, longer hospital stay and poorer outcome. A low grade chronic infflammatory state in obesity and hypoadiponectinemia can enable the cytokine storm and exaggerated /dysregulated SIRS in obese patients after surgery. Obesity according to this knowledge presents independent risk factor for developing more severe systemic infflamatory response syndrome in early postoperative period after major abdominal surgery. Also, chronic intestinal and gut infflamation is leading theory in oncogenesis of colorectal carcinoma according to recent findings. Many studies find low adiponectin levels in patients with colorectal carcinoma compared to healthy population. Obesity and colorectal cancer have infflamation and low adiponectin level as mutual factor which can be the important key in pathophysiology process of colorectal oncogenesis which are extremly complicated , multifactorial and intertwining.

Hypothesis: Lower blood adiponectin levels are associated with higher systemic infflamatory response in patients after major abdominal surgery. Major aim of this study is to investigate correlation between perioperative blood levels of adiponectin and clinical signs of systemic infflamation and blood markers of systemic infflamation in patients after major colorectal surgery.

Conditions

• Obesity, Abdominal
• Surgery
• Systemic Inflammatory Response Syndrome
• Postoperative Complications
• Colorectal Carcinoma (CRC)
• Adiponectin

Interventions

DIAGNOSTIC_TEST

serum levels of adiponectin

adiponectin level will be measured on a day of surgery, 24 hours and 72 hours after surgery

DIAGNOSTIC_TEST

IL-6

IL-6 level will be measured on a day of surgery, 24 hours and 72 hours after surgery

OTHER

Postoperative systemic infflamation

systemic infflamatory response syndrome (SIRS) will be estimated in firs 72 hours after surgery by clinical criteria: apperance of at least 2 from 4 major clinical signs of SIRS: heart rate\>90/min, body temperature \>38 C or \<36 C, WBC \>12 000 or \<4000, hyperventilation, CRP \>50mg/L, PCT \> 0.5 ug/L.

OTHER

Postoperative complications

Complications in early postoperative period during hospitalisation will be including: surgical operation site related: anastomotic or laparotomic dehiscence, wound/local infection, postoperative bleeding, reoperation and nonsurgical site complications: sepsis, pneumonia, noncardiac respiratory failure, (need for noninvasive oxygen therapy), prolonged mechanical ventilation \>24 hours postoperative, reintubation, repeated mechanical ventilation atrial fibrillation, congestive heart failure, myocardial infarction, acute kidney injury/failure, postoperative delirium. Length of ICU and overall hospital stay with after discharge from hospital will be documented.

Sponsors & Collaborators

• Osijek University Hospital

  lead OTHER

Principal Investigators

• Slavica Kvolik · Department of Anaesthesiology, Resuscitation and ICU, Osijek University Hospital,

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-27

Primary Completion

2025-05-01

Completion

2025-08-22

Countries

• Croatia

Study Locations