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Khirurgii

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Year 2023 Vol. 31 No 6

SCIENTIFIC PUBLICATIONS

A.L. LIPNITSKI 1, 2, А.V. MAROCHKOV 1, 2, I.Y. SAVOSTENKO 1, A.V. VYUKHINA 1, E.L. STAVCHIKOV 1, 2, I.G. TISHKEVICH 1

ASSESSMENT OF SURGICAL INVASIVENESS BY THE DYNAMICS OF SERUM IRON AND C-REACTIVE PROTEIN LEVELS

Mogilev Regional Clinical Hospital 1, Mogilev,
Vitebsk State Order of Peoples’ Friendship Medical University 2, Mogilev, Republic of Belarus

Objective. The aim of the study was to examine the possibility of using C-reactive protein and serum iron levels in patients in the perioperative period as a quantitative criterion of surgical invasiveness.
Methods. A retrospective non-randomized observational study was conducted and was approved by the ethics committee. The study involved 125 patients who underwent the following surgical interventions: total knee replacement (n=44), radical phlebectomy (n=34), otolaryngological surgery (n=12), open heart cardiac surgery (n= 33). All patients underwent blood sampling to determine the content of CRP and serum iron at the following stages: stage 1 – before surgery; stage 2 – 20-24 hours after surgery; stage 3 – 48-72 hours after surgery.
Results. At stage 1 of the study (before surgery), the content of CRP in the blood serum in all patients was 1.73 (0.54; 4.09) mg/l; at stage 2 (20-24 hours after surgery), a significant increase in CRP was observed to 29.92 (14.02; 68.3) mg/l (p<0.05). At stage 3 (48-72 hours after surgery), the content of CRP also significantly increased compared to stage 1 and stage 2 – 65.77 (29.03; 124) mg/l (p<0.05). The serum iron at stage 1 of the study in all patients was 18.41 (13.23; 23.05) mmol/l. 20-24 hours after surgery, the iron level decreased statistically significantly to 5.36 (3.87; 8.48) mmol/l (p<0.001). At stage 3, the iron level did not change significantly compared to stage 2 – 6.09 (4.05; 9.1) mmol/l (p>0.05).
The correlation analysis showed the presence of a statistically significant negative correlation between the level of C-reactive protein and serum iron in the postoperative period: at stage 2 – R=-0.37, p=0.0017; at stage 3 – R=-0.68, p<0.0001.
Conclusion. Analysis of the dynamics of the level of C-reactive protein and serum iron can be an independent criterion for surgical traumatism and can be used for quantitative comparison of operations in different anatomical areas.

Keywords: C-reactive protein, serum iron, traumatism of surgical interventions, surgical traumatism criteria, surgical invasiveness
p. 431-438 of the original issue
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Address for correspondence:
212016, Republic of Belarus,
Mogilev, Belynitsky-Biruli st. 12,
Mogilev Regional Clinical Hospital,
Department for Coordinating the Collection
of Organs and Tissues for Transplantation,
tel.: +375 222 62-75-95,
e-mail: Lipnitski.al@gmail.com,
Lipnitsky Artur L.
Information about the authors:
Lipnitsky Artur Leonidovich, PhD, Anesthesiologist-Resuscitator, Head of the Department for Coordinating the Collection of Organs and Tissues for Transplantation, Mogilev Regional Clinical Hospital, Associate Professor of the Branch of the Departments of Anesthesiology and Resuscitation with a Course of FPK and PC and Hospital Surgery with a Course of FPK and PC EE «Vitebsk State Medical University», Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-2556-4801
Marochkov Alexey Viktorovich, MD, professor, Anesthesiologist-Resuscitator of the Department of Anesthesiology and Resuscitation, Mogilev Regional Clinical Hospital, Professor of the Branch of the Departments of Anesthesiology and Resuscitation with a Course of FPK and PK and Hospital Surgery with a Course of FPK and PK. Vitebsk Institution State Medical University», Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-5092-8315
Savostenko Igor Yakovlevich, Surgeon, Department Of Surgery, Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0009-0004-4751-5551
Vyukhina Elena Vladimirovna, Otorhinolaryngologist, Head of the Otorhinolaryngology Department of the Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0009-0004-9029-9962
Stavchikov Evgeny Leonidovich, Surgeon of the Department of Purulent Surgery of the Mogilev Regional Clinical Hospital, Senior Lecturer of the Branch of the Departments of Anesthesiology and Resuscitation with a Course of FPK and PC and Hospital Surgery with a Course of FPK and PC of the Vitebsk State Medical University, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-5147-5274
Tishkevich Igor Gennadievich, Cardiac Surgeon, Department of Cardiac Surgery, Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0003-3616-1933
Contacts | ©Vitebsk State Medical University, 2007-2023