Systemic stress responses in patients undergoing surgery for benign prostatic hyperplasia

Abstract

and group 3, prostate > 80 g, treated with a suprapubic transvesical prostatectomy (TP). Blood samples were taken from each patient on the day before and the day after surgery, and the acute-phase reactants and antioxidants measured; cortisol concentrations were also measured in 24-h urine samples the day before and 3 days after surgery. RESULTSThere were significantly higher levels of cortisol, CRP and TAS, and significantly lower levels of fibrinogen and SOD in all study groups after surgery than before. Surgery and associated conditions, e.g. excitement, fear, blood loss, etc., lead to traumatic and oxidative stress, followed by a strong systemic stress response during and after surgery. Low fibrinogen levels after surgery had a different pattern from the other acute-phase reactants, as a result of increased fibrinolytic activity after TURP and TP. CONCLUSION

Surgical Sepsis and Organ Crosstalk: The Role of the Kidney

“…Oxidative stress occurs as a component of the surgical stress response, particularly after IRI, sepsis, kidney and liver failure [91-93]. Oxidative stress also plays an important role in sepsis-associated AKI.…”

Oxidative Stress in Relation to Surgery: Is There a Role for the Antioxidant Melatonin?

“…The authors concluded that the severity of surgery was pivotal in determining the degree of oxidative stress response. TP triggered the strongest stress response and greatest trauma, whereas the stress response was moderate after TURP and least after TUIP [12].…”

“…Levels of malondialdehyde and carbonyl proteins were significantly higher in the open hernia repair group when compared with the laparoscopic group. Ruzic et al [12] evaluated the systemic stress response in patients undergoing three different types of surgery [transurethral incision of the prostate (TUIP), transurethral resection of the prostate (TURP), and suprapubic transvesical prostatectomy (TP)] for benign prostatic hyperplasia. They measured urinary cortisol, serum C-reactive protein, serum fibrinogen, serum TPAS, and serum superoxide dismutase (SOD) both pre-and postoperatively.…”

“…The pathophysiological mechanism behind a disturbed circadian rhythm of melatonin secretion is not known. Factors such as magnitude of surgery [12,48], anesthesia [64], perioperative administration of certain drugs (benzodiazepines [65], ␤-blockers [66], calcium channel blockers [67], nonsteroidal anti-inflammatory drugs [68], and dexamethasone), nocturnal light [69 -71], hepatic metabolism, activation of the hypothalamo-pituitary-adrenal axis [72,73], and use of opioid analgesics [74] may all affect postoperative melatonin secretion. Whether reduced endogenous secretion of melatonin after surgery has a negative effect on the oxidative status and results in increased morbidity remains to be investigated.…”

Cortisol levels and serum antioxidant status following chemotherapy

“…Cortisol levels are affected by the circadian cycle with highest values observed early in the morning. Increased cortisol concentrations are measured in blood serum of people under biological or emotional stress, depression, sleep deprivation, fever, hypoglycemia, anorexia nervosa and after surgery [26][27][28]. A 3% -10% increase in cortisol levels has been observed in cancer patients varying according to the severity of the disease [29].…”