| Objective To characterize perioperative levels of circulating Ghrelin in relation to different surgical procedures. To study the regulation effect of Ghrelin on stress response and the correlation between Ghrelin and inflammatory cytokines.Methods This study is a non-randomized controlled trial.44 patients with rectal cancer were analyzed.22 of them received open surgery, while 22 of them received laparoscopic surgery. Besides operative time, length of hospital stay, blood loss and length of bowel function recovery, other outcomes measured included levels of Ghrelin, C-reactive protein, TNF-α, cortisol, IL-6, IL-8 andα-1 antitrypsin 6,12,24,36,48,72 hours after surgery.Results There were statistical differences between two groups in operative indicators P<0.05. Blood sample analysis documented an elevation of Ghrelin, with a maximum 24 hours after the start of surgery in both groups. Ghrelin elevation in control group was significantly higher in relation to both preoperative levels in control group P<0.01 and maximal postoperative levels in experimental group P<0.05. Ghrelin concentrations returned to preoperative status 36-48 hours after surgery. Maximal postoperative levels of all tested parameters except for cortisol differed significantly between both groups p< 0.05. The related coefficient was the highest for Ghrelin and TNF-α24 hours after surgery (r=0.64, p< 0.05) and for Ghrelin and IL-6 24 hours after surgery (r=0.56, p<0.05). Conclusion An inflammatory response can lead to an increase in Ghrelin plasma concentrations, and its intensity depends on the intensity of the inflammatory stress stimulus. |
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