Abstract
Background. According to the literature, multiorgan resections are carried out with the most radical removal of healthy tissue. Therefore, there is a need for the most favorable preparation of the patient with perioperative therapy to reduce further complications with obtaining improved clinical and pathological prognostic indicators to increase the overall survival. Purpose: correction of redox metabolism based on the data of the oxidative modification of proteins, degree of their catabolic reaction, and data on the enzymatic state and lipid peroxidation in cancer patients with multiorgan resections on the gastrointestinal tract under conditions of perioperative intensive care. Materials and methods. The study involved 117 cancer patients aged 67.6 ± 3.7 years with locally advanced tumor processes of the gastrointestinal tract. Studies have been conducted on the enzymatic state, lipid peroxidation and oxidative modification of proteins, both in terms of the degree of fragmentation of their products in spontaneous and iron-induced reactions, and the level of medium-weight protein molecules. Serum levels of circulating tumor necrosis factor alpha, interleukin-6 and -8 were determined. Survival analysis was performed using the Kaplan-Meier method. Results. The study of patients has shown an improvement in the indicators of oxidative modification of proteins and lipid peroxidation. Survival in cancer patients with multiorgan resections demonstrated dependence on the levels of tumor necrosis factor alpha, interleukin-6 and -8 in the blood serum. Conclusions. Conducting perioperative intensive care makes it possible to reliably restore indicators of the enzymatic state, lipid peroxidation and oxidative protein modification products (on the fourth day and second week, p < 0.05). This gives us grounds for recommending the determination of these parameters in the group of cancer patients and the implementation of metabolic intensive care. In the group of L-ornithine L-aspartate and quercetin combination with povidone, the lowest indicators of systemic chronic inflammation and the best overall survival were found.
Highlights
Gastrointestinal cancer is one of the most common causes of death from neoplasms in European countries, and more than 3.4 million people die from it every year in the world [1]
It is interesting to study the improvement of redox metabolism [11] and markers of systemic chronic inflammation, provided that the intensive care described by us is used to further reduce the incidence of complications and mortality
In patients with multiorgan resections, significant violations of protein metabolism were detected with an increase in prooxidant processes, manifested itself by an increase in the products of oxidative modification of proteins in the preoperative period, followed by a decrease on the 4th day and the 2nd week of the postoperative period, in both spontaneous and induced reactions
Summary
Gastrointestinal cancer is one of the most common causes of death from neoplasms in European countries, and more than 3.4 million people die from it every year in the world [1]. The activi ty of redox metabolism and markers of systemic chronic inflammation increases during the formation of oxidative stress [7, 8] Their laboratory control is feasible in all conditions involving intoxication and the development of stress in the body, especially during multiorgan resections in cancer patients. Purpose: correction of redox metabolism based on the data of the oxidative modification of proteins, degree of their catabolic reaction, and data on the enzymatic state and lipid peroxidation in cancer patients with multiorgan resections on the gastrointestinal tract under conditions of perioperative intensive care. Conducting perioperative intensive care makes it possible to reliably restore indicators of the enzymatic state, lipid peroxidation and oxidative protein modification products (on the fourth day and second week, p < 0.05) This gives us grounds for recommending the determination of these parameters in the group of cancer patients and the implementation of metabolic intensive care.
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