Neuroendocrine Aspects of Surgical Stress

2015 ◽  
pp. 106-120
Author(s):  
Herschel L. Estep
Keyword(s):  
Surgical Stress

Platelet Function in Surgical Stress

1985 ◽  
Vol 54 (04) ◽  
pp. 849-852 ◽  
Author(s):  
O Naesh ◽  
J T Friis ◽  
I Hindberg ◽  
K Winther
Keyword(s):  
Stress Response ◽  
Negative Correlation ◽  
Surgical Stress ◽  
Plasma Concentrations ◽  
Serum Cortisol ◽  
Cortisol Concentration ◽  
Pulmonary Dysfunction ◽  
Arterial Po2 ◽  
Elective Cholecystectomy ◽  
Serum Cortisol Concentration

SummaryTen patients for elective cholecystectomy were studied pre-, per- and postoperatively. All had neurolept anesthesia. Plasma concentrations of β-TG, TXB2 and 5-HT and intraplatelet 5-HT were measured. Aggregation to ADP was recorded.Serum cortisol concentration was used as index of the stress response, showing peroperative increase and postoperative decrease. Closely related to this we observed a significant increase in P-β-TG and P-TXB2 with postoperative normalization in 6 patients without complications. P-5-HT had a peak peropera-tively and remained elevated postoperatively. A negative correlation between P--5-HT and decreasing intraplatelet 5-HT postoperatively was observed.High postoperative levels of P--5-HT seem to be related to low arterial Po2 and pulmonary dysfunction. In 3 patients with complications a second increase in P-β-TG, P-TXB2 and partly in P--5-HT was found. Platelets were temporarily refractory to ADP immediately following surgery and showed increased aggregabil-ity postoperatively. We conclude that platelets are activated in surgical stress.

Recovery of Muscular Performance After Surgical Stress in Elderly Patients

2014 ◽  
Vol 20 (19) ◽  
pp. 3215-3221 ◽  
Author(s):  
I. Bautmans ◽  
N. Winkel ◽  
A. Ackerman ◽  
L. Dobbeleer ◽  
E. Waele ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Surgical Stress ◽  
Muscular Performance

scholarly journals Biological impact of an enhanced recovery after surgery programme in liver surgery

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
S Gonvers ◽  
J Jurt ◽  
G -R Joliat ◽  
N Halkic ◽  
E Melloul ◽  
...  
Keyword(s):  
Liver Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Stress ◽  
Multivariable Analysis ◽  
Albumin Concentration ◽  
Biological Impact ◽  
Reactive Protein ◽  
Before And After ◽  
Major Resection

Abstract Background The clinical and economic impacts of enhanced recovery after surgery (ERAS) programmes have been demonstrated extensively. Whether ERAS protocols also have a biological effect remains unclear. This study aimed to investigate the biological impact of an ERAS programme in patients undergoing liver surgery. Methods A retrospective analysis of patients undergoing liver surgery (2010–2018) was undertaken. Patients operated before and after ERAS implementation in 2013 were compared. Surrogate markers of surgical stress were monitored: white blood cell count (WBC), C-reactive protein (CRP) level, albumin concentration, and haematocrit. Their perioperative fluctuations were defined as Δvalues, calculated on postoperative day (POD) 0 for Δalbumin and Δhaematocrit and POD 2 for ΔWBC and ΔCRP. Results A total of 541 patients were included, with 223 and 318 patients in non-ERAS and ERAS groups respectively. Groups were comparable, except for higher rates of laparoscopy (24.8 versus 11.2 per cent; P < 0.001) and major resection (47.5 versus 38.1 per cent; P = 0.035) in the ERAS group. Patients in the ERAS group showed attenuated ΔWBC (2.00 versus 2.75 g/l; P = 0.013), ΔCRP (60 versus 101 mg/l; P <0.001) and Δalbumin (12 versus 16 g/l; P < 0.001) compared with those in the no-ERAS group. Subgroup analysis of open resection showed similar results. Multivariable analysis identified ERAS as the only independent factor associated with high ΔWBC (odds ratio (OR) 0.65, 95 per cent c.i. 0.43 to 0.98; P = 0.038), ΔCRP (OR 0.41, 0.23 to 0.73; P = 0.003) and Δalbumin (OR 0.40, 95 per cent c.i. 0.22 to 0.72; P = 0.002). Conclusion Compared with conventional management, implementation of ERAS was associated with an attenuated stress response in patients undergoing liver surgery.

scholarly journals Spontaneous regression of breast cancer with immune response: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Masahiro Ohara ◽  
Yumiko Koi ◽  
Tatsunari Sasada ◽  
Keiko Kajitani ◽  
Seishi Mizuno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Immune Responses ◽  
Needle Biopsy ◽  
Spontaneous Regression ◽  
Ductal Carcinoma ◽  
Surgical Stress ◽  
Fibrous Tissue ◽  
Coagulation Necrosis ◽  
Surgical Specimen ◽  
The Right

Abstract Background Spontaneous regression (SR) is a rare phenomenon in which a cancer disappears or remits without treatment. We report a case of breast cancer that showed spontaneous tumor regression in the surgical specimen after core needle biopsy. Case presentation A 59-year-old woman came to our hospital complaining of a painful lump in the right breast. In the upper-outer quadrant of the right breast, a tumor with an unclear boundary, 30 mm in diameter, was palpable. In pathological findings from needle biopsy, the tumor was diagnosed as solid-type invasive ductal breast carcinoma. Partial coagulation necrosis was generated in estrogen receptor-negative, HER2-negative, and AE1/AE3-positive ductal carcinoma without infiltration of lymphocytes. Surgery for right breast cancer was then performed. Histological examination of the surgical specimen revealed the tumor was invasive ductal carcinoma with lymphocyte infiltration, coagulation necrosis, and fibrous tissue with hemosiderin. The tumor formed a solid nest, 3 mm in diameter, suggesting the possibility of SR. Conclusions Immune responses, infection, hormones, surgical stress, and ischemia have been reported as mechanisms of SR. The findings in this case strongly suggest that SR of breast cancer is associated with anti-tumor immune responses.

Measuring the severity of surgical stress in newborn infants

1988 ◽  
Vol 23 (4) ◽  
pp. 297-305 ◽  
Author(s):  
Kanwal J.S. Anand ◽  
A. Aynsley-Green
Keyword(s):  
Surgical Stress ◽  
Newborn Infants

Application of proton NMR spectroscopy to measurement of whole-body RNA degradation rates: effects of surgical stress in human patients

1996 ◽  
Vol 252 (2) ◽  
pp. 123-135 ◽  
Author(s):  
Jaspaul S. Marway ◽  
Graeme J. Anderson ◽  
John P. Miell ◽  
Richard Ross ◽  
George K. Grimble ◽  
...  
Keyword(s):  
Nmr Spectroscopy ◽  
Surgical Stress ◽  
Proton Nmr ◽  
Rna Degradation ◽  
Whole Body ◽  
Proton Nmr Spectroscopy ◽  
Degradation Rates

EFFECTS OF GENERAL ANAESTHESIA AND SEVERITY OF SURGICAL STRESS ON SERUM LH AND TESTOSTERONE IN MALES

1975 ◽  
Vol 78 (2) ◽  
pp. 258-269 ◽  
Author(s):  
A. Nakashima ◽  
K. Koshiyama ◽  
T. Uozumi ◽  
Y. Monden ◽  
Y. Hamanaka ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Surgical Stress ◽  
Fiberoptic Bronchoscopy ◽  
Serum Testosterone ◽  
Major Surgery ◽  
Succinylcholine Chloride ◽  
Serum Luteinizing Hormone ◽  
Serum Lh ◽  
Rate Of Increase ◽  
Male Patients

ABSTRACT Significantly decreased levels of serum testosterone from the pre-anaesthesia level were found during and up to 7 days following major surgery under general anaesthesia (nitrous oxide, oxygen and halothane following induction with thiopental and succinylcholine chloride) in 18 male patients. On the other hand, in the same patients, the serum luteinizing hormone (LH) increased significantly from the pre-anaesthesia level 30 min and 1 h after the beginning of anaesthesia. A slight increase in LH level was also noted on the 7th post-operative day. The determinations of serum testosterone and LH in fiberoptic bronchoscopy under the same general anaesthesia as that used in surgery or local anaesthesia in 26 male patients, revealed that the change in the serum LH during and following surgery seemed to be mainly induced by the general anaesthesia and that the rate of decrease in the serum testosterone may be related to the severity of surgical stress including the anaesthesia. The rate of increase in serum testosterone following the injection of gonadotrophin in 20 males on the 6th post-operative day was similar to that in 10 pre-operative males. The effects of pulmonary lobectomy on serum testosterone and urinary steroids were also studied in 6 males under adrenal suppression with dexamethasone. On the 6th post-operative day, the urinary aetiocholanolone plus androsterone and serum testosterone were found to be half the level of those on the pre-operative day, while the urinary 5β-pregnane-3α,17α,20α-triol remained unchanged. These observations in human are not inconsistent with the report of Tcholakian & Eik-Nes (1971) in dogs namely that a shift in androgen biosynthetic pathway is present in the testis under surgical stress.

scholarly journals Postoperative Albumin Drop Is a Marker for Surgical Stress and a Predictor for Clinical Outcome: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Martin Hübner ◽  
Styliani Mantziari ◽  
Nicolas Demartines ◽  
François Pralong ◽  
Pauline Coti-Bertrand ◽  
...  
Keyword(s):  
Stress Response ◽  
Pilot Study ◽  
Clinical Outcomes ◽  
Surgical Stress ◽  
Major Surgery ◽  
Surgical Trauma ◽  
Once Daily ◽  
Reactive Protein ◽  
Estimated Blood Loss ◽  
Postoperative Stress

Background. Surgical stress during major surgery may be related to adverse clinical outcomes and early quantification of stress response would be useful to allow prompt interventions. The aim of this study was to evaluate the acute phase protein albumin in the context of the postoperative stress response.Methods. This prospective pilot study included 70 patients undergoing frequent abdominal procedures of different magnitude. Albumin (Alb) and C-reactive protein (CRP) levels were measured once daily starting the day before surgery until postoperative day (POD) 5. Maximal Alb decrease (Alb Δ min) was correlated with clinical parameters of surgical stress, postoperative complications, and length of stay.Results. Albumin values dropped immediately after surgery by about 10 g/L (42.2±4.5 g/L preoperativelyversus33.8±5.3 g/L at day 1,P<0.001). Alb Δ min was correlated with operation length (Pearsonρ=0.470,P<0.001), estimated blood loss (ρ=0.605,P<0.001), and maximal CRP values (ρ=0.391,P=0.002). Alb Δ min levels were significantly higher in patients having complications (10.0±5.4versus6.1±5.2,P=0.005) and a longer hospital stay (ρ=0.285,P<0.020).Conclusion. Early postoperative albumin drop appeared to reflect the magnitude of surgical trauma and was correlated with adverse clinical outcomes. Its promising role as early marker for stress response deserves further prospective evaluation.

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