An investigation into the relationship between the perioperative systemic inflammatory response and postoperative complications in patients undergoing surgery for colorectal cancer

Ramanathan, Michelle L. (2015) An investigation into the relationship between the perioperative systemic inflammatory response and postoperative complications in patients undergoing surgery for colorectal cancer. PhD thesis, University of Glasgow.

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Abstract

Colorectal cancer is the second most common cause of cancer death in the western world.
Despite improvements in diagnosis and treatment, 50% of patients still die from this
disease. It is now recognised that postoperative infective complications contribute to poor
cancer specific survival following resection for colorectal cancer. The basis of this
observation is not clear. One hypothesis is that the presence of a raised systemic
inflammatory response may be responsible. Whether a raised postoperative inflammatory
response is the result of an early underlying infection at a preclinical stage, or whether a
raised inflammatory response leads to increased susceptibility to subsequent infection is
not known. If the former proves true, it is possible that targeting at risk patients with pre
emptive antibiotics may reduce infective complications and improve patient outcomes.
Conversely, if the latter is the case, perioperative intervention to reduce the postoperative
inflammatory response may reduce infective complications and hence improve outcomes,
both short and long term, for patients undergoing colorectal cancer resection.
The work presented in this thesis further examines the relationship between the systemic
inflammatory response and postoperative infective complications following resection for
colorectal cancer, determines predictive thresholds for the development of postoperative
infective complications, assesses the impact of the peak systemic inflammatory response
on these thresholds and investigates the determinants of the peak response. Finally, the
question as to whether a raised postoperative systemic inflammatory response is the cause
or consequence of infective complications is examined.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: colorectal cancer, systemic inflammatory response, infective complications, C-reactive protein.
Subjects: R Medicine > RD Surgery
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Supervisor's Name: Horgan, Professor Paul
Date of Award: 2015
Depositing User: Miss Michelle L Ramanathan
Unique ID: glathesis:2015-6914
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 07 Dec 2015 16:10
Last Modified: 29 Nov 2016 08:28
URI: http://theses.gla.ac.uk/id/eprint/6914

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