Inflammatory Response After Colorectal Cancer Surgery (CRC)

Inflammatory Response Following Colorectal Cancer Surgery Depends on the Type of Anesthesia and Surgery

Laparoscopic technique and epidural anesthesia have been proposed to improve postoperative outcome following colorectal cancer surgery. The investigators hypothesize that the inflammatory response is attenuated by laparoscopic surgery and epidural anesthesia compared to traditional open surgery under general anesthesia.

Patients scheduled for open colorectal cancer surgery were randomly allocated to receive general anesthesia (CON group, n=22) or general anesthesia with thoracic epidural anesthesia (EPI group, n=21). Patients undergoing laparoscopic surgery (LAP group, n=20) composed the third arm of the study. Measurement of perioperative changes in several hormones and cytokines were blinded to group assignment. Primary outcome: Compare simultaneously two types of surgical and anesthesia techniques for colorectal cancer surgery and measure to what extent the stress response is lessened.

We have compared colorectal cancer surgery under two types of surgical(laparoscopic versus open) and anesthesia (thoracic epidural versus general) techniques

We have measured and compared perioperative plasma levels of interleukin-1, interleukin-2, interleukin-6,monocyte chemotactic protein-1, interleukin-8, nitric oxide, C-reactive protein and procalcitonin in our three-group sample.

We have analyzed if there is any significant difference on respiratory, cardiac, renal or infectious postoperative complications between groups

Inclusion Criteria: Patients scheduled for colorectal cancer surgery Exclusion Criteria: Emergent surgery Intestinal obstruction Contraindication for epidural catheter placement Concomitant autoimmune disease Concomitant infectious disease Recent corticosteroids or anti-inflammatory medications