期刊
CELLS
卷 11, 期 20, 页码 -出版社
MDPI
DOI: 10.3390/cells11203314
关键词
leukocyte disorders; outcome; leukopenia; agranulocytosis; hematologic diseases; postoperative complications; surgery
类别
资金
- Baden-Wuerttemberg Ministry of Science, Research, and Art
- University of Freiburg
Leukocytes play a crucial role in the immune system and cell-cell interaction in the human body. Diseases and chemotherapy can lead to leukocyte deficiency, particularly neutropenia. Neutropenia increases the risk of infection and may cause healing disorders. Neutropenic patients requiring emergency surgery have a higher mortality risk compared to non-neutropenic patients. However, there is no clear tendency for a higher mortality risk in neutropenic patients undergoing elective surgery. Further research is needed to evaluate the risk of postoperative complications in neutropenic patients and the role of neutrophilic function in morbidity and mortality.
Leukocytes are essential for the function of the immune system and cell-cell interaction in the human body, but hematological diseases as well as chemotherapeutic treatments due to cancer lead to occasionally or even permanent leukocyte deficiency. Normally, more than 50% of leukocytes are neutrophilic granulocytes, and leukopenia is, therefore, mostly characterized by a decrease in neutrophilic granulocytes. The consequence of neutropenia is increased susceptibility to infection, but also healing disorders are suggestable due to the disturbed cell-cell interaction. While there is no surgical treatment for leucocyte disorders, patients suffering from neutropenia are sometimes in need of surgery for other reasons. Less is known about the morbidity and mortality of this patients, which is why this narrative review critically summarizes the results of recent research in this particular field. The results of this review suggest that neutropenic patients in need of emergency surgery have a higher mortality risk compared to non-neutropenic patients. In contrast, in elective surgery, there was not a clear tendency for a higher mortality risk of neutropenic patients. The role of neutrophilic granulocytes in inflammation and immunity in surgical patients is emphasized by the results, but most of the evaluated studies showed methodological flaws due to small sample sizes or risk of bias. Further research has to evaluate the risk for postoperative complications, particularly of infectious complications such as surgical site infections, in neutropenic patients undergoing elective surgery, and should address the role of neutrophilic function in postoperative morbidity and mortality.
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