J.Jpn. Surg. Soc.. 91(9): 1166-1169, 1990

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Report on the annual meeting

CHANGES OF CHEMICAL MEDIATORS AFTER MAJOR SURGERY AND POSTOPERATIVE COMPLICATIONS

The present study was performed to investigate the role of various chemical mediators in the development of complications after major surgery. Phospholipase A₂ activity (PLA₂), and the levels of Pancreatic secretory trypsin inhibitor (PSTI), polymorphonuclear leukocyte elastase (PMNE), thromboxane B₂(TxB₂), 6-keto-PGF_1α(6-KF), leukotriene (LT)B₄, C₄, D₄, interleukin-β (IL-1β), tumor necrosis factor (TNF), and endotoxin (Et) in the serum were measured in 94 operated cases, of which postoperative complications developed in 14 and 4 cases died of multiple organ failure (MOF).
PLA₂, arterial TxB₂ and 6-KF demonstrated significant changes in the patients with postoperative complications, accompanying the elevation of Et levels. The majority of these patients had significantly high ratio of TxB₂/6-KF. On the other hand, all 3 patients with high 6-KF and low or normal TxB₂/6-KF ratio died of MOF with hepatic failure. These results suggest TxB₂ and 6-KF, and TxB₂/6-KF ratio are the useful indices to predict the prognosis of postoperative critically ill patients with hepatic failure.
LTB₄, C₄, D₄ were increased in the patients with postoperative sepsis or DIC, especially at their initial onsets.
The increased levels of IL-1β or TNF were observed in some of patients with postoperative complications, and especially, severe postoperative complications developed in 3 of 4 patients, in whom TNF was detected.

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