Nayan Agarwal, Juhil D Nanavati, DNB, Neeraj Dhamija, DNB, Brij B Agarwal, MS, Satish Saluja, MD. Sir Ganga Ram Hospital & GRIPMER, India
INTRODUCTION: Enhanced recovery after surgery (ERAS) in post-operative convalescence (POC) following minimally invasive surgery (MIS) is determined by sterile inflammation which is mediated by an interplay between pro/anti-inflammatory and immunosuppressive cytokine cascades (PAIKn). The PAIKn & POC vary, even in similar surgeries. Damage associated molecular patterns (DAMPs) trigger PAIKn, driven dominantly by interleukine-6 (IL6). Heat shock protein (HSP), the thermal equivalent of DAMP, has distinct IL6- PAIKn footprint. We studied the patient-specific markers for subjective POC & PAIKn association, in ERAS compatible clinical-pathway for index MIS i.e.cholecystectomy.
METHODS AND PROCEDURES: (RCT-Clinical trials registry, India. REF/2014/06/007153). Randomization to energy use or non-use was done for HSP being the dominant/ potential confounder. Patient demographics perioperative data, PAIKn markers & hepatopancreatic data [ juxta-operative(H0),at 4-hours(H4)&at 24-hours(H24)], were prospectively collated.
|Gender||M = 29, F = 71|
|Kuppuswamy Socio-Economic Class||Upper = 20, Upper-middle = 32, Lower-middle = 36, Upper-lower = 11, Lower = 1|
|Substance abuse||Alcohol=24, Smokers=14|
|GB perforation||Occured in 26 patients|
|Return to normal act||4.95(2-36)days|
|IL-6||6.808 (0.22-135.8)||24.9549 (2-485.48)||28.0373 (1.39-442)|
|HS-CRP||0.8985 (0.02-21.37)||1.30885 (0.02-21.77)||3.6922 (0.05-24.6)|
|TNF α||9.4306 (0.02-38.6)||12.8645(0.02-39.1)||14.3929(0.71-61.9)|
Data(following standard scales/metrics)for Patient-Reported-Outcomes e.g. pain, nausea-vomiting, & fatigue will be analyzed with the above data and the analysis with conclusions will be presented & discussed.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87843
Program Number: P357
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster