ABSTRACT
Cytokines are expressed by various cells after several stimuli such as surgical tissue damage, producing a systemic inflammatory response (SIR). C-reactive protein (CRP) is used extensively in clinical practice after operative injury, but proinflammatory cytokines, iron status, albumin, neutrophil-to-lymphocyte (N/L) ratio and hemoglobin, as acute phase reactants, have been poorly documented. This study aims to show how they behave after surgery, comparing laparoscopic (LC) versus open cholecystectomy (OC). In total, 55 patients were included in a prospective non-randomized form to undergo a cholecystectomy: 8 patients OC (50% females) and 47 patients LC (68% females). Before (A1) and 24 h after surgery (A2), blood samples were taken for an ordinary analysis and IL6, IL8 and TNFα determination. There were no differences between LC and OC groups concerning age, CRP, IL6 and TNFα at day A1. In the LC group at day A2, CRP, IL6, IL8, TNF, ferritin, leukocytes and N/L ratio increased; hemoglobin, lymphocytes, prothrombin and albumin decreased (p < 0.05). In the OC group at day A2, only IL6 (p < 0,07), ferritin, leukocytes, N/L ratio and CRP (p < 0.05) increased; serum iron, hemoglobin, lymphocytes and albumin (p < 0.05) decreased. At day A2, OC vs. LC group, higher values were observed in IL6, ferritin and CRP (p ≤ 0.05), and lesser values were observed in serum iron and prothrombin (p < 0.05). In conclusion, classic markers of inflammation are altered after surgery, in a milder way in laparoscopic surgery. Ferritin can be used as an inflammatory marker, as has been described in COVID-19 infection.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Shock, Hemorrhagic/complications , Splenic Rupture/etiology , Hematoma/diagnostic imaging , Hemoperitoneum/surgery , Adenocarcinoma/surgery , Colonic Neoplasms/surgery , Splenic Diseases/diagnostic imaging , Rupture, Spontaneous , Splenic Rupture/diagnostic imaging , Abdominal Pain/etiology , Tomography, X-Ray Computed , Laparotomy , Adenocarcinoma/drug therapy , Colonic Neoplasms/pathologySubject(s)
Shock, Hemorrhagic/etiology , Splenic Neoplasms/complications , Splenic Rupture/complications , Aged , Humans , MaleABSTRACT
Los tumores retroperitoneales son lesiones infrecuentes. Las tumoraciones nerviosas benignas como los schwannomas representan menos del 3% de ellos, siendo extremadamente raros los que afectan el nervio obturador. Presentamos el caso de un paciente con importante afectación funcional en miembro inferior izquierdo y dolor pélvico, al que se le diagnosticó neoplasia retroperitoneal. Fue intervenido por vía laparoscópica objetivándose la dependencia de la lesión del nervio obturador. Se llevó a cabo una exéresis completa de la lesión preservando parcialmente el nervio. El paciente tuvo una evolución funcional y álgica muy favorable. La anatomía patología reveló la presencia de schwannoma, del denominado subtipo "anciano", sin datos de malignidad. Consideramos que el informe de un caso como este puede ayudar a conocer una patología muy infrecuente y a tener en consideración algunos puntos clave como la técnica de abordaje y la necesidad de preservación de las estructuras nerviosas.
Retroperitoneal tumors are uncommon; benign tumors originating in the nerve cells as schwannomas represent less than 3%, while schwannomas of the obturator nerve are extremely rare. We report the case of a male patient with significant functional compromise of the left lower limb and pelvic pain who was diagnosed with a retroperitoneal tumor. The patient underwent laparoscopic surgery during which the compromise of the obturator nerve was evident. The lesion was completely resected with partial preservation of the nerve. The patient progressed with favorable functional recovery and pain relief. The histopathological examination reported a benign ancient schwannoma. We believe that this case report can help to understand a very rare condition and consider some key points such as the technique of approach and the need for preservation of the nerve structures.
Subject(s)
Humans , Male , Aged , Retroperitoneal Neoplasms/surgery , Neurilemmoma/surgery , Obturator Nerve/injuries , Arthroplasty/adverse effects , Magnetic Resonance Spectroscopy/methods , Tomography, X-Ray Computed/methods , Colonoscopy/methods , Laparoscopy/methods , Neuralgia/diagnostic imaging , Neurilemmoma/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Colonic Neoplasms/pathology , Liver Neoplasms/secondary , Tuberculosis, Hepatic , Neoplasm Metastasis , Immunosuppression Therapy , Tomography, X-Ray Computed , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/drug therapy , Microwaves/therapeutic use , Isoniazid/administration & dosage , Pyrazinamide/administration & dosage , Rifampin/administration & dosageSubject(s)
Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Ileal Diseases/complications , Intestinal Fistula/complications , Intestinal Obstruction/etiology , Intestine, Small , Jejunal Diseases/complications , Aged, 80 and over , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Ulcer Agents/administration & dosage , Anti-Ulcer Agents/adverse effects , Aspirin/administration & dosage , Aspirin/adverse effects , Female , Humans , Ileal Diseases/chemically induced , Ileal Diseases/diagnostic imaging , Intestinal Fistula/chemically induced , Intestinal Obstruction/diagnostic imaging , Intestinal Perforation/chemically induced , Intestinal Perforation/diagnostic imaging , Jejunal Diseases/chemically induced , Jejunal Diseases/diagnostic imaging , Omeprazole/administration & dosage , Omeprazole/adverse effects , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Abdominal Pain/etiology , Appendicitis/complications , Postoperative Complications/etiology , Appendectomy , Appendicitis/pathology , Appendicitis/surgery , Appendix/pathology , Chronic Disease , Laparoscopy , Postoperative Complications/pathologyABSTRACT
No disponible
