Does hyperthermic preconditioning affect the rate of surgical site infection rate and inflammatory reaction in colorectal cancer patients? A prospective randomized clinical trial

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Objective: Hyperthermic preconditioning has been shown to protect against different insults in experimental studies. However, clinical studies assessing its effects remain limited. The aim of this study was to investigate the effectsof hyperthermic preconditioning on the rate of surgical site infection and inflammatory reaction in patients undergoing elective colorectal cancer surgery.Material and methods: Patients with colorectal cancer, scheduled to undergo elective surgery were enrolled in thisprospective randomized study. Patients were randomly assigned to either the hyperthermic preconditioning groupor control group. Postoperative superficial and deep surgical site infection were recorded. Blood samples werecollected from all the patients in the hyperthermic preconditioning group prior to the application of hyperthermia12 h before surgery, immediately prior to surgery, and 4 h and 24 h postoperatively. For the control group, bloodsamples were obtained within the same periods without the application of hyperthermia. Levels of interleukin-1,IL-6, and tumor necrosis factor-α were measured from blood samples.Results: Twenty patients were randomized to the hyperthermic preconditioning group and 21 to the control group.No significant difference was found in deep or superficial surgical site infection between the groups. No significantdifference in the tumor necrosis factor-α, interleukin-1, and IL-6 levels was found in serum samples collected beforehyperthermia, during the operation, and postoperatively.Conclusion: This study showed that hyperthermic preconditioning has no effect on the surgical site infection andcytokine response in patients undergoing elective surgical intervention for colorectal cancer.