{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T15:31:07Z","timestamp":1759332667949},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transthoracic esophagectomy for cancer triggers a massive inflammatory reaction. The data whether a minimally invasive esophagectomy (MIE) leads to less pronounced inflammatory response compared to open right\u2010sided transthoracic esophagectomy (OE) are scarce. The aim of this study was to evaluate the extent of the inflammatory reaction, represented by levels of the pro\u2010inflammatory interleukins IL\u20106 and IL\u20108, the anti\u2010inflammatory IL\u20101 RA and the chemokines CINC\u20101 and MCP\u20101\u00a0in the right pleural fluid and the blood from patients undergoing standard OE or MIE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pleural drainage fluid and blood was collected at five different time points during the first 72 h following surgery, and the concentrations of IL\u20106, IL\u20108, IL\u20101 RA, CINC\u20101 and MCP\u20101 were analyzed using enzyme\u2010linked immune\u2010sorbent assays in 24 patients undergoing MIE or OE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The groups were matched for cancer stage and comorbidities. Pro\u2010 and anti\u2010inflammatory mediator levels in the pleural fluid were markedly increased at the end of surgery and on postoperative days 1\u20133. The pleural inflammatory response of all cyto\u2010 and chemokines was lower in the MIE group, reaching significance at some time points. Cyto\u2010 and chemokine response levels measured in the blood were overall lower compared to those in the pleural fluid. The chemokines CINC\u20101 and MCP\u20101 reacted less pronounced or not at all. Preoperative pulmonary comorbidity, postoperative pulmonary morbidity and length of surgery were associated with an increased reaction in selected mediators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The minimally invasive technique attenuates the inflammatory response, especially locally in the thoracic compartment. Length of procedure, preoperative pulmonary comorbidity and postoperative pulmonary complications are mirrored in an increase in individual inflammatory markers in the pleural fluid. The value of the chemokines CINC\u20101 and MCP\u20101 as markers of inflammation in the setting of esophagectomy is unclear.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05069-w","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T16:03:50Z","timestamp":1561046630000},"page":"2631-2639","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cytokine Response in the Pleural Fluid and Blood in Minimally Invasive and Open Esophagectomy"],"prefix":"10.1002","volume":"43","author":[{"given":"T.","family":"Delko","sequence":"first","affiliation":[{"name":"Department of Surgery Flinders University Bedford Park Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. 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