Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

Ying LI; Ping LIANG

doi:10.3969/j.issn.1001-5256.2021.08.028

Volume 37 Issue 8

Aug. 2021

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(8): 1894-1897

PDF( 1868 KB)

Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

DOI: 10.3969/j.issn.1001-5256.2021.08.028

Ying LI^,,
Ping LIANG

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Army Medical University, PLA, Chongqing 400036, China

Received Date: 2020-12-29
Accepted Date: 2021-03-04
Published Date: 2021-08-20

Abstract

Abstract

Objective To investigate the association between perioperative immune status and postoperative infectious complications in elderly patients undergoing laparoscopic pancreaticoduodenectomy (LPD), as well as the effect of thymosin a1 on postoperative complications. Methods Related clinical data were collected from 43 elderly patients, aged 66-83 years, who underwent LPD in The Second Affiliated Hospital of Army Medical University, PLA from June 2014 to June 2018, and the patients were divided into combination group with 22 patients (with the application of thymosin a1 in the perioperative period) and control group with 21 patients (without the application of thymosin a1). Immune function parameters were observed before surgery and on days 3 and 7 after surgery, including serum levels of IgG, IgA, and IgM, peripheral blood neutrophil-lymphocyte ratio (NLR), changes in CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio, and the incidence rate of postoperative infectious complications (pulmonary infection, pancreatic leakage, and abdominal infection). In addition, the serum levels of C-reactive protein, interleukin-2 (IL-2), interleukin-10 (IL-10), tumor necrosis factor-α, and interferon-γ (IFN-γ) were measured before surgery and on days 3 and 7 after surgery. The t-test was used for comparison of continuous data between two groups; a repeated measures analysis of variance was used for comparison within each group at different time points, and the Duncan's new multiple range test was used for further pairwise comparison. The chi-square test was used for comparison of categorical data between groups. Results Compared with the control group on days 3 and 7 after surgery, the combination group had significantly higher serum levels of IgG, IgA, IgM, CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio (all P < 0.05) and a significantly lower NLR (P < 0.05). From admission to day 7 after surgery, the control group had significant reductions in the serum levels of IgG, IgA, IgM, CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ ratio (all P < 0.05) and a significant increase in NLR (P < 0.05). The combination group had significantly lower incidence rates of postoperative pulmonary infection and abdominal infection than the control group (χ²=1.44, 1.65, all P < 0.05). Compared with the control group on days 3 and 7 after surgery, the combination group had significant increases in the serum levels of IL-2, IL-10, and IFN-γ (all P < 0.05). Conclusion Surgical trauma can further reduce the immune function of elderly patients, and the use of thymosin a1 during the perioperative period can enhance the immune function of patients and reduce the incidence rate of postoperative infectious complications.
- Pancreaticoduodenectomy,
- Aged,
- Perioperative Period,
- Postoperative Complications

FullText(HTML)

References(16)

References

[1]	UMEMURA A, NITTA H, TAKAHARA T, et al. Current status of laparoscopic pancreaticoduodenectomy and pancreatectomy[J]. Asian J Surg, 2018, 41(2): 106-114. DOI: 10.1016/j.asjsur.2016.09.003.
[2]	CHEN ZC, LIU J. Current status and perspectives of laparoscopic pancreaticoduodenctomy[J]. J Clin Hepatol, 2018, 34(9): 2027-2032. DOI: 10.3969/j.issn.1001-5256.2018.09.042. 陈志诚, 刘军. 腹腔镜胰十二指肠切除术的应用现状及展望[J]. 临床肝胆病杂志, 2018, 34(9): 2027-2032. DOI: 10.3969/j.issn.1001-5256.2018.09.042.
[3]	SUKHARAMWALA P, THOENS J, SZUCHMACHER M, et al. Advanced age is a risk factor for post-operative complications and mortality after a pancreaticoduodenectomy: A meta-analysis and systematic review[J]. HPB (Oxford), 2012, 14(10): 649-657. DOI: 10.1111/j.1477-2574.2012.00506.x.
[4]	AREZZO A, PASSERA R, SALVAI A, et al. Laparoscopy for rectal cancer is oncologically adequate: A systematic review and meta-analysis of the literature[J]. Surg Endosc, 2015, 29(2): 334-348. DOI: 10.1007/s00464-014-3686-4.
[5]	BELLET MM, BORGHI M, PARIANO M, et al. Thymosin alpha 1 exerts beneficial extrapulmonary effects in cystic fibrosis[J]. Eur J Med Chem, 2021, 209: 112921. DOI: 10.1016/j.ejmech.2020.112921.
[6]	LIU Q, ZHAO Z, ZHANG X, et al. Robotic pancreaticoduodenectomy in elderly and younger patients: A retrospective cohort study[J]. Int J Surg, 2020, 81: 61-65. DOI: 10.1016/j.ijsu.2020.07.049.
[7]	PARK DJ, HAN SU, HYUNG WJ, et al. Long-term outcomes after laparoscopy-assisted gastrectomy for advanced gastric cancer: A large-scale multicenter retrospective study[J]. Surg Endosc, 2012, 26(6): 1548-53. DOI: 10.1007/s00464-011-2065-7.
[8]	WU JM, ZHAO LY, CHEN T, et al. Vascular injury and anatomy during laparoscopy - assisted distal gastrectomy with D2 lymphadenectomy for gastric cancer[J]. Chin J Gastrointestinal Surg, 2019, 22(10): 955-960. DOI: 10.3760/cma.j.issn.1671-0274.2019.10.010. 吴佳明, 赵丽瑛, 陈韬, 等. 腹腔镜远端胃癌D2根治术中血管损伤及其解剖特点[J]. 中华胃肠外科杂志, 2019, 22(10): 955-960. DOI: 10.3760/cma.j.issn.1671-0274.2019.10.010.
[9]	CHOI M, HWANG HK, RHO SY, et al. Comparing laparoscopic and open pancreaticoduodenectomy in patients with pancreatic head cancer: Oncologic outcomes and inflammatory scores[J]. J Hepatobiliary Pancreat Sci, 2020, 27(3): 124-131. DOI: 10.1002/jhbp.697.
[10]	PICA F, GAZIANO R, CASALINUOVO IA, et al. Serum thymosin alpha 1 levels in normal and pathological conditions[J]. Expert Opin Biol Ther, 2018, 18(sup1): 13-21. DOI: 10.1080/14712598.2018.1474197.
[11]	LIU M, JI S, XU W, et al. Laparoscopic pancreaticoduodenectomy: Are the best times coming?[J]. World J Surg Oncol, 2019, 17(1): 81. DOI: 10.1186/s12957-019-1624-6.
[12]	ZHANG Y, HONG D, ZHANG C, et al. Total laparoscopic versus robot-assisted laparoscopic pancreaticoduodenectomy[J]. Biosci Trends, 2018, 12(5): 484-490. DOI: 10.5582/bst.2018.01236.
[13]	PIETRASZ D, PITTAU G, SA CUNHA A. Laparoscopic pancreaticoduodenectomy: Patients' interest should be the goal of health care[J]. Minerva Chir, 2019, 74(3): 237-240. DOI: 10.23736/S0026-4733.18.07956-7.
[14]	MAHER H, JIN W, MOU Y, et al. The prospective of laparoscopic pancreaticoduodenectomy for cancer management[J]. Chin Clin Oncol, 2017, 6(1): 8. DOI: 10.21037/cco.2017.01.03.
[15]	KAMARAJAH SK, BUNDRED J, MARC OS, et al. Robotic versus conventional laparoscopic pancreaticoduodenectomy a systematic review and meta-analysis[J]. Eur J Surg Oncol, 2020, 46(1): 6-14. DOI: 10.1016/j.ejso.2019.08.007.
[16]	ZHANG H, LAN X, PENG B, et al. Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis[J]. World J Gastroenterol, 2019, 25(37): 5711-5731. DOI: 10.3748/wjg.v25.i37.5711.

Relative Articles

Supplements(0)

Cited By

Cited by
Periodical cited type(0)
Other cited types(1)

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(3)

Get Citation

PDF

XML

Article Metrics

Article views (560) PDF downloads(27)

Effect of thymosin a1 on complications after laparoscopic pancreaticoduodenectomy in elderly patients

DOI: 10.3969/j.issn.1001-5256.2021.08.028

Abstract

References

Cited by

Periodical cited type(0)

Other cited types(1)

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content