Journal
ANTIOXIDANTS
Volume 10, Issue 7, Pages -Publisher
MDPI
DOI: 10.3390/antiox10070999
Keywords
colorectal cancer; ferric reducing antioxidant power (FRAP); total antioxidant capacity; superoxide dismutase; glutathione peroxidase; surgical trauma; robotic surgery; postoperative ileus; anastomotic leak; antioxidant intervention
Funding
- Ministry of Science and Higher Education [016/RID/2019/19]
- European Regional Development Fund, within the Innovative Economy Operational Program 2007-2013
- Project WroVasc-Integrated Cardiovascular Centre
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This study aims to understand the changes in antioxidant capacity, including TAC, FRAP, SOD, and GPx, in patients undergoing surgery, especially in older, obese, and comorbid patients. The time frame between 8 and 24 h post-incision is crucial for antioxidant-based interventions, as seen in the transient increase in FRAP and TAC, and the significant changes in SOD and GPx activities.
A better understanding of antioxidant status, its modifiers, and its effect on clinical outcomes in patients undergoing colorectal cancer surgery is needed for effective antioxidant-based interventions. The objectives of this cohort study were: to determine baseline serum (total antioxidant capacity (TAC) and ferric reducing antioxidant power (FRAP); n = 72) and erythrocyte (superoxide dismutase (SOD) and glutathione peroxidase (GPx); n = 47) antioxidant capacity and time-course during the 72 h postoperative period, to identify potential modifiers, and to establish impact on clinical outcomes. Older patients with comorbidities had lower baseline FRAP. TAC was inversely and SOD directly correlated with inflammatory markers. Cancer pathology affected GPx (lower in advanced and more aggressive cancers) and SOD (higher in advanced cancers). Surgical intervention induced a transient increase in FRAP and TAC with greater FRAP elevation in older, obese patients with several comorbidities. SOD activity significantly increased while GPx non-significantly decreased between 8 and 24 h post-incision. Poorer health status was associated with an increase in SOD and a decrease in GPx at 72 h. Clinical manifestation of postoperative ileus was preceded by decreased TAC at 24 h and an increase in SOD between 8 and 24 h and anastomotic leak was manifested by diminished SOD at 72 h compared to activities at 8 and 24 h. The time-frame between 8 and 24 h post-incision might be the most critical regarding oxidant/antioxidant balance and therefore the best suited for antioxidant-based intervention.
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