Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation.
Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation.
复制标题
胃癌胰腺非接触式胃切除术可预防术后炎症。
DOI：
10.1007/s00464-021-08961-6
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Hiki N.
中科院分区：
文献类型：
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作者：
Ushiku H;Sakuraya M;Washio M;Hosoda K;Niihara M;Harada H;Miura H;Sato T;Nishizawa N;Tajima H;Kaizu T;Kato H;Sengoku N;Tanaka K;Naitoh T;Kumamoto Y;Sangai T;Yamashita K;Hiki N.
背景腹腔镜胃癌切除术（LG）后胰腺相关并发症可能是致命的。我们开发了一种胃切除术，没有胰腺接触，以防止这种并发症，并在此报告的手术outcome.MethodsWe回顾性分析了182例胃癌患者在北里大学医院接受LG从2017年1月至2020年1月。这些患者被分为胰腺接触组（C组）和胰腺非接触组结果CL组CDc分级为Ⅲ a的术后并发症明显少于C组[0/76（0%）vs. 6/106（5.7%），P= 0.035]。中位引流淀粉酶CL组术后第1天（POD 1）的（引流-AMY）显著低于C组（641 vs. 1162 IU/L，P= 0.02），与POD 1时的BT相同（37.4 ℃ vs. 37.7 ℃，P= 0.04），POD 3时BT高于37.5 ℃的患者组[5/76（6.5%）vs. 18/106（17%），P= 0.037]，以及在POD 3时CRP高于20.0 mg/dL的患者[5/76（6.5%）与20/106（19%），P= 0.018]。结论我们的技术，以防止胰腺接触，在超-在LG期间进行胰淋巴结清扫可减少炎症反应并防止进一步的术后并发症。现在需要进一步的大规模前瞻性研究。
BackgroundPancreas-related complications after laparoscopic gastrectomy (LG) for gastric cancer can be fatal. We developed a gastrectomy procedure with no pancreas contact to prevent such complications and herein report the surgical outcomes.MethodsWe retrospectively reviewed 182 consecutive patients with gastric cancer who underwent LG at Kitasato University Hospital from January 2017 to January 2020. These patients were divided into a pancreas-contact group (C group) and pancreas-contactless group (CL group) for comparison of postoperative complications, and inflammatory parameters such as body temperature (BT) and C-reactive protein (CRP).ResultsPostoperative complications of CDc grade ≧ IIIa were significantly fewer in the CL group than in the C group [0/76 (0%) vs. 6/106 (5.7%),P= 0.035]. The median drain amylase (drain-AMY) on postoperative day 1 (POD1) was significantly lower in the CL group than in the C group (641 vs. 1162 IU/L,P= 0.02), as was BT at POD1 (37.4 °C vs. 37.7 °C,P= 0.04), the patient group with a BT above 37.5 °C at POD3 [5/76 (6.5%) vs. 18/106 (17%),P= 0.037], and those showing a CRP above 20.0 mg/dL at POD3 [5/76 (6.5%) vs. 20/106 (19%),P= 0.018].ConclusionsOur technique to prevent pancreas contact during supra-pancreatic lymph node dissection during LG could minimize the inflammatory response and prevent further postoperative complications. Further large-scale, prospective studies are now required.