RESUMEN
Objective To examine the relationship between the perioperative changes in cytokines and the postoperative complications after esophagecotomy. Methods Twenty-five ASA Ⅱ-Ⅲ patients undergoing esophagectomy were divided into two groups: group A without postoperative complication (n = 17), group B with postoperative complications including pulmonary infection (in 2 patients), pleural effusion (in 3 patients), cardiac arrhythmia(in 2 patients) and anastomosis hemorrage(in 1 patient) (n = 8). Blood samples were taken before anesthesia(T0 ), at skin incision(T1), 2h after chest was opened(T2 ), 60 min after lungs were inflated (T3) and 1,4, 24h after surgery (T4, T5, T6 ) for determination of serum IL-6, IL-8 and IL-10 concentrations. The durations of SIRS, the definition of which was set by American College of Chest Physicians /Society of Critical Care Medicine (ACCP/SCCM), was also recorded. Results The demographic data including age, sex and body weight were comparable between the two groups. There was also no significant difference in preoperative lung function, duration of surgery, blood loss during surgery and duration of unilateral lung ventilation between the two groups. The duration of SIRS was shorter in group A than that in group B. In both groups serum IL-6 and IL-8 levels increased significantly at T2 (after thoracotomy) reached their peak values at T4, and then gradually declined but were still significantly higher than the baseline values(T0). The serum IL-6 level was significantly higher at T6 (24h after surgery) in group B than that in group A. The serum IL-8 level was significantly higher at T3-6 in group B than that in group A. The IL-6/IL-10 and IL-8/IL-10 ratio were significantly lower at T5-6 in group A than those in group B. Conclusions The postoperative complications may occur due to the inflammatory response, and/or anti-inflammatory mediators insufficiency. The IL-6/IL-10 and IL-8/IL-10ratio may be of value in predicting the prognosis.