Influences of Surgical Aggression on Non-specific Host Defence System in Gastoroenterological Surgery

Takashi Kodama, Mitsuaki Okita, Yoshio Takesue, Mikio Fujimoto, Hitoshi Sewake, Yoshiaki Murakami, Yuuji Imamura, Hiroaki Tsumura, Katsunari Miyamoto, Yuichirou Matsuura, Takashi Yokoyama*, Eiso Hiyama*

First Department of Surgery, Hiroshima University School of Medicine
*Department of General Medicine, Hiroshima University School of Medicine

To study the influence of surgical defense system, granulocyte function (Luminol dependent chemiluminescence, elastase release) and plasma levels of the acute phase proteins were measured. Blood samples were obtained continuously before and after surgery from 93 patients with gall-stones, cancer of the stomach or cancer of the colon and rectum. Immediately after the operation, granulocyte function was increased but plasma levels of the acute phase proteins were decreased. The increase in the granulocyte function and the drop in the plasma levels of the acute phase proteins in the patients with cancer of the colon and recutm or stomach were more severe than those in the patients with gallstones. Furthermore, these values returned to the preoperative levels much earlier in the latter group. These changes almost paralleled the degree of the surgical aggresion. It was therefore suspected that the changes caused by surgical aggression might easily lead to tissue damage by the granulocytes. Considering that-postoperative infection occurs in these immunocompromised states, it is necessary to deal carefully with such infections.

Key words
surgical aggression, granulocyte function, acute phase proteins

Reprint requests
Takashi Kodama First Department of Surgery, Hiroshima University School of Medicine
1-2-3 Kasumi, Minami-ku, Hiroshima, 734 JAPAN

Accepted
January 10, 1990

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