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Measuring serum and drainage fluid interleukin-6 and tumor necrosis factor-α levels for early detection of infectious complications after minimally invasive surgery for gastric cancer. | LitMetric

AI Article Synopsis

  • - The study investigated whether measuring levels of inflammatory cytokines IL-6 and TNF-α in patients post-gastrectomy can help identify infectious complications early on, focusing on those measured on postoperative day 1 (POD 1).
  • - Results showed that higher levels of IL-6 and TNF-α in both serum and drainage fluid were significantly associated with postoperative infections, with IL-6 levels in particular providing strong diagnostic value for detecting issues such as intra-abdominal abscesses.
  • - The findings suggest that IL-6 levels measured in blood (over 47 pg/mL) and drainage fluid (over 14,750 pg/mL) can be useful indicators for early detection of infections after minimally invasive surgery

Article Abstract

Objective: Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) are inflammatory cytokines produced in response to biological invasion or infection. Their levels are elevated in the blood and locally. We examined whether measuring IL-6 and TNF-α levels in serum or drainage fluid on postoperative day (POD) 1 could detect infectious complications after minimally invasive surgery for gastric cancer.

Methods: This cohort study included 205 consecutive patients who underwent laparoscopic or robot-assisted gastrectomy for gastric cancer between November 2020 and July 2023. We measured serum and drainage fluid IL-6 and TNF-α levels on POD 1 after gastrectomy. Receiver operating characteristic (ROC) curves were created to compare the diagnostic values of each cytokine and serum C-reactive protein levels for detecting postoperative infectious complications.

Results: IL-6 and TNF-α levels in the serum or drainage fluid were significantly higher in patients with an infectious complication. In addition, drainage fluid IL-6 levels were significantly different in patients with versus without intra-abdominal abscess. In the ROC curve analysis, serum and drainage fluid IL-6 had the highest AUC values for any infectious complication and intra-abdominal abscess, respectively. POD 1 serum IL-6 level above 47 pg/mL could detect any infectious complication with sensitivity of 74.1 % and specificity of 71.8 %. POD 1 drainage fluid IL-6 level above 14,750 pg/mL had 100 % sensitivity for detecting intra-abdominal abscess with specificity of 56.0 %.

Conclusions: Measurement of IL-6 levels in blood and drainage fluid on POD 1 is valuable for early detection of postoperative infectious complications or intra-abdominal abscess after gastric cancer surgery.

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Source
http://dx.doi.org/10.1016/j.ejso.2024.108564DOI Listing

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