Can serum tumor necrosis factor-alpha predict peritoneal adhesions prior to secondary laparoscopic procedures?

Abstract

Aim of the study: This study aimed to investigate the incidence and degree of postoperative intra-abdominal adhesions(POAs) in secondary laparoscopic procedures and assess the power of the preoperative levels of tumor necrosis factor-alpha(TNF-?) and interleukin-1 beta(IL-1?) and selected peripheral inflammatory biomarkers(PIBs) in the prediction of the development and extent of POA. Patients and methods: This prospective study enrolled 103 patients who had previously undergone at least one or more laparoscopic abdominal or gynecological operations. We examined TNF-?, IL-1?, and PIBs, namely C-reactive protein, white blood cell count, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio, and systemic immune-inflammation index(SII) according to the presence, location, and score of adhesions determined during secondary laparoscopic procedures. Results: Only age, postoperative adhesion index(PAI) score, NLR, SII, TNF-?, and IL-1? resulted in a significant difference in the existence of adhesion(P < 0.05). The correlation analysis of TNF-? with variables showed that the PAI score and IL 1? levels had a significantly positive correlation. Conclusion: The presence and extent of POA could be predicted by examining the preoperative TNF-? level in patients who had laparoscopic abdominal surgery previously. We could overcome adverse events during secondary laparoscopic procedures by assessing high-risk patients and integrating a personalized surgical approach to managing selected patients.