1Division of Colon and Rectal Surgery, Department of Surgery, St Luke's-Roosevelt Hospital Center, New York, New York 2Division of Colon and Rectal Surgery, Ferguson Clinic/Spectrum Health Medical Group, Grand Rapids, Michigan 3Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, New York.
Dis Colon Rectum. 2014 Jun;57(6):740-6. doi: 10.1097/DCR.0000000000000062.
Minimally invasive colorectal resection for cancer is associated with increased plasma levels of numerous proangiogenic proteins for 3 to 4 weeks postoperatively, and plasma from postoperative weeks 2 and 3 stimulates proangiogenic endothelial cell behavior in vitro. It is unknown if similar plasma changes occur after minimally invasive colorectal resection for benign pathology.
The aim of this study is to assess 1) plasma levels of angiopoetin-2, placental growth factor, and soluble vascular cell adhesion molecule-1 after minimally invasive colorectal resection for benign pathology and 2) postoperative plasma's effects on in vitro endothelial cell proliferation (branch point formation), migration, and invasion.
Prospectively gathered plasma samples taken from patients undergoing colorectal resection who consented to participate in an institutional review board-approved plasma and data bank were used for ELISAs and in vitro endothelial cell studies.
The plasma and clinical data used were collected at 3 hospitals.
Patients undergoing minimally invasive colorectal resection for benign indications who were enrolled in a plasma/data bank and for whom adequate samples and volumes of plasma were available were included in the study.
Perioperative plasma levels of angiopoetin-2, placental growth factor, and soluble vascular cell adhesion molecule-1 were the primary outcomes measured. In vitro rates of endothelial cell branch point formation, migration, and invasion were determined after the addition of preoperative and postoperative plasma samples to endothelial cell cultures.
Plasma from 86 patients undergoing minimally invasive colorectal resection for benign indications was assessed (diverticulitis, 30; benign polyps, 56). Plasma levels of angiopoetin-2, placental growth factor, and soluble vascular cell adhesion molecule-1 were significantly increased for 3 to 4 weeks postoperatively compared with preoperative levels. In regard to the endothelial cell culture assays, significantly increased endothelial cell branch point formation, invasion, and migration results were noted with plasma from the second and third weeks postoperatively in comparison with preoperative culture results.
The weaknesses of this study are the limited numbers of late postoperative plasma samples and the need to bundle late samples into 7- to 12-day time blocks.
Minimally invasive colorectal resection for benign pathology is associated with persistent proangiogenic plasma alterations similar to those found in patients who have cancer. Surgical trauma and not the indication is the likely cause.
微创结直肠切除术治疗癌症后 3 至 4 周内，大量促血管生成蛋白的血浆水平升高，第 2 周和第 3 周的术后血浆可刺激体外促血管生成内皮细胞的行为。目前尚不清楚微创结直肠切除术治疗良性病变后是否会发生类似的血浆变化。
本研究旨在评估 1）微创结直肠切除术后良性病变患者的血管生成素-2、胎盘生长因子和可溶性血管细胞黏附分子-1 的血浆水平，2）术后血浆对体外内皮细胞增殖（分支点形成）、迁移和侵袭的影响。
前瞻性收集接受结直肠切除术且同意参与机构审查委员会批准的血浆和数据库的患者的血浆样本，用于 ELISA 和体外内皮细胞研究。
血浆和临床数据收集于 3 家医院。
纳入研究的患者为接受微创结直肠切除术治疗良性疾病的患者，入组了血浆/数据库，并且有足够的样本和血浆量。
围手术期血管生成素-2、胎盘生长因子和可溶性血管细胞黏附分子-1 的血浆水平为主要观察指标。将术前和术后血浆样本加入内皮细胞培养物中，测定体外内皮细胞分支点形成、迁移和侵袭的速度。
评估了 86 例因良性指征接受微创结直肠切除术的患者的血浆（憩室炎 30 例，良性息肉 56 例）。与术前水平相比，术后 3 至 4 周，血管生成素-2、胎盘生长因子和可溶性血管细胞黏附分子-1 的血浆水平显著升高。关于内皮细胞培养试验，与术前培养结果相比，术后第 2 周和第 3 周的血浆使内皮细胞分支点形成、侵袭和迁移的结果显著增加。
本研究的局限性在于晚期术后血浆样本数量有限，以及需要将晚期样本捆绑到 7-12 天的时间块中。
微创结直肠切除术治疗良性病变与在癌症患者中发现的类似的持续促血管生成性血浆改变有关。导致这种改变的可能是手术创伤而不是手术指征。
Zotero 插件