Peritoneal inflammation and fatigue experiences following colorectal surgery: A pilot study

A Prospective Case-Control Study of the Local and Systemic Cytokine Response After Laparoscopic Versus Open Colonic Surgery

“…The lower level of peritoneal fluid IL-6 after laparoscopic colonic surgery is a novel finding in the literature. In addition we directly correlated cytokine levels measured with postsurgical recovery, and the results support previously postulated relationships [12]. Hewitt et al randomized 16 patients to laparoscopic and open colonic resection for neoplasia, and sampled peritoneal fluid at the end of surgery.…”

“…There is a sequential, high concentration cytokine response after major abdominal surgery [6][7][8]. This contributes to the systemic hemodynamic instability and global metabolic derangement that is observed postoperatively [9][10][11], and is thought to be a determinant of postoperative fatigue, which can last for up to 3 mo after surgery [12].…”

The Humoral Response After Laparoscopic Versus Open Colorectal Surgery: A Meta-Analysis

“…Even after these physiological parameters have seemingly recovered, postoperative patient fatigue can persist, lasting for up to 3 mo after major uncomplicated gastrointestinal operations [9,10]. Research studies into fatigue suggest a complex bio-psycho-social etiology [11], but there is recent evidence that postsurgical inflammatory responses may directly influence its development [12].…”

The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial

“…The physical theory asserts that PSF is mainly the result of metabolic and inflammatory responses resulting in a decline in physical fitness as exemplified by reductions in skeletal muscle and cardiorespiratory functioning [25]. In addition, we have shown that intraperitoneal cytokine levels are directly correlated with the PSF experience in patients undergoing abdominal surgery [26]. These changes are believed to cause a direct effect on the central nervous system (CNS) by the vagus nerve and have been targets of biological intervention, including glucocorticoids and intraperitoneal signal dampening, with positive effects [27,28].…”