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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2022.tde-03042023-152447
Document
Author
Full name
Denise Quinto
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Passerotti, Carlo Camargo (President)
Silva, Marco Antonio Nunes da
Chade, Daher Cezar
Cruz, José Arnaldo Shiomi da
Title in Portuguese
Avaliação da resposta inflamatória sistêmica na prostatectomia radical e retropúbica e sua correlação com parâmetros clínicos, cirúrgicos e patológicos
Keywords in Portuguese
Câncer de Próstata
Cirurgia
Citocinas
TNF
Abstract in Portuguese
Introdução: A prostatectomia radical retropúbica (PRR) aberta é o principal tratamento para pacientes com câncer de próstata localizado, porém, nos últimos anos técnicas laparoscópicas vem despertando o interesse de urologistas. Entre essas técnicas podemos destacar a prostatectomia radical laparoscópica robótica (PRLR). Poucos estudos comparam esses dois procedimentos em relação à extensão do trauma cirúrgico e a resposta inflamatória sistêmica gerada em resposta. Objetivos: Nesse estudo propomos comparar o estresse cirúrgico e a fase aguda da resposta inflamatória de maneira prospectiva e controlada entre a PRLR e PRR. Métodos: Para isso, coletamos amostras de soro de 40 pacientes submetidas a PRLR e de 20 pacientes submetidos à PRR em quatro diferentes momentos. As citocinas IL-4, IL-8, IL-6, IL-1B, IL-10 e TNF, usadas como marcadores inflamatórios, foram mensuradas utilizando ensaios de ELISA/Multiplex e xMAP-Luminex. Resultados: Em ambas as cirurgias, IL-6 e IL-10 foram maiores no T4 em comparação ao T1-T3 (p=0,001). Além disso, IL-6 e IL-10 estavam em maior concentração no T4 da PRR em comparação com a PRLR (p= 0.001 e p= 0.000, respectivamente). Conclusão: A menor concentração sérica dos marcadores inflamatórios na PRLR nos permite concluir que esse procedimento causa uma diminuição da resposta inflamatória em relação à técnica padrão (PRR)
Title in English
Evaluation of the systemic inflammatory response in radical and retropubic prostatectomy and its correlation with clinical, surgical, and pathological parameters
Keywords in English
Cytokines
Prostate Cancer
Surgery
TNF
Abstract in English
Background: Radical retropubic prostatectomy (PRR) is the standard treatment for patients with clinically localized prostate cancer, however, in the last years laparoscopic techniques have aroused interest in urologists. One of these techniques is robotically assisted laparoscopic RP (RALP). Only a few reports are available on the extent of surgical trauma and the subsequent systemic inflammatory response in patients undergoing these two procedures. Aim: In this work, we propose to compare surgical stress and the systemic response of the acute phase in a prospective and controlled setting between RALP and PRR. Methods: For this, we collected serum samples from 40 patients undergoing RALP and 20 patients undergoing PRR at four different times. The cytokines IL-4, IL-8, IL-6, IL-1B, IL-10 and TNF were detected using ELISA/Multiplex assays and xMAP - Luminex. Results: In both surgeries, IL6 and IL-10 were higher in T4 compared with T1-T3 (p=0.001). IL-6 and IL-10 were higher in T4 in PRR compared to RALP (p=0.001 and p=0.000, respectively). Conclusions: The lower serum concentration of inflammatory markers in PRLR allows us to conclude that this procedure causes a decrease in the inflammatory response compared to the standard technique (PRR)
 
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Publishing Date
2023-04-17
 
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