Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation
Background Pancreas-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. Methods We retrospectively reviewed 182 consecutive pati...
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| Veröffentlicht in: | Surgical endoscopy 2022-08, Vol.36 (8), p.5644-5651 |
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| creator | Ushiku, Hideki Sakuraya, Mikiko Washio, Marie Hosoda, Kei Niihara, Masahiro Harada, Hiroki Miura, Hirohisa Sato, Takeo Nishizawa, Nobuyuki Tajima, Hiroshi Kaizu, Takashi Kato, Hiroshi Sengoku, Norihiko Tanaka, Kiyoshi Naitoh, Takeshi Kumamoto, Yusuke Sangai, Takafumi Yamashita, Keishi Hiki, Naoki |
| description | Background
Pancreas-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.
Methods
We 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).
Results
Postoperative 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].
Conclusions
Our 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. |
| doi_str_mv | 10.1007/s00464-021-08961-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2616610145</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2689392727</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-cc4e27fdca976961d24c3cd58a412196266ae025c4102f1008a08a75dbe5f1e63</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMoun78AQ9S8OIlmknTtDnK4hcIelA8hphOly5tU5Pswv57o_UDPAiBMOTJOzMPIcfAzoGx8iIwJqSgjANllZJA5RaZgcg55RyqbTJjKmeUl0rskf0QlizxCopdspcLVQHP2Yy8PJrBejSBWjdEY2OHIWQLE6JHG12_yRrnp7q1mU0w-mz0uMYhhmx0IboRvYntGrN2aDrT96lwwyHZaUwX8OjrPiDP11dP81t6_3BzN7-8p1YIiNRagbxsamtUKdMKNRc2t3VRGQEclORSGmS8sAIYb9LWlUmnLOpXLBpAmR-Qsyl39O5thSHqvg0Wu84M6FZBcwlSAgNRJPT0D7p0Kz-k6RJVqVzxkpeJ4hNlvQvBY6NH3_bGbzQw_aFdT9p10q4_teuPKU6-olevPdY_X749JyCfgJCehgX6397_xL4DoKiOJw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2689392727</pqid></control><display><type>article</type><title>Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation</title><source>SpringerLink (Online service)</source><creator>Ushiku, Hideki ; Sakuraya, Mikiko ; Washio, Marie ; Hosoda, Kei ; Niihara, Masahiro ; Harada, Hiroki ; Miura, Hirohisa ; Sato, Takeo ; Nishizawa, Nobuyuki ; Tajima, Hiroshi ; Kaizu, Takashi ; Kato, Hiroshi ; Sengoku, Norihiko ; Tanaka, Kiyoshi ; Naitoh, Takeshi ; Kumamoto, Yusuke ; Sangai, Takafumi ; Yamashita, Keishi ; Hiki, Naoki</creator><creatorcontrib>Ushiku, Hideki ; Sakuraya, Mikiko ; Washio, Marie ; Hosoda, Kei ; Niihara, Masahiro ; Harada, Hiroki ; Miura, Hirohisa ; Sato, Takeo ; Nishizawa, Nobuyuki ; Tajima, Hiroshi ; Kaizu, Takashi ; Kato, Hiroshi ; Sengoku, Norihiko ; Tanaka, Kiyoshi ; Naitoh, Takeshi ; Kumamoto, Yusuke ; Sangai, Takafumi ; Yamashita, Keishi ; Hiki, Naoki</creatorcontrib><description>Background
Pancreas-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.
Methods
We 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).
Results
Postoperative 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].
Conclusions
Our 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.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-021-08961-6</identifier><identifier>PMID: 34981230</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Laparoscopy ; Medicine ; Medicine & Public Health ; Pancreas ; Postoperative period ; Proctology ; Surgery ; Surgical outcomes</subject><ispartof>Surgical endoscopy, 2022-08, Vol.36 (8), p.5644-5651</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-cc4e27fdca976961d24c3cd58a412196266ae025c4102f1008a08a75dbe5f1e63</citedby><cites>FETCH-LOGICAL-c441t-cc4e27fdca976961d24c3cd58a412196266ae025c4102f1008a08a75dbe5f1e63</cites><orcidid>0000-0002-6857-8736</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-021-08961-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-021-08961-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34981230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ushiku, Hideki</creatorcontrib><creatorcontrib>Sakuraya, Mikiko</creatorcontrib><creatorcontrib>Washio, Marie</creatorcontrib><creatorcontrib>Hosoda, Kei</creatorcontrib><creatorcontrib>Niihara, Masahiro</creatorcontrib><creatorcontrib>Harada, Hiroki</creatorcontrib><creatorcontrib>Miura, Hirohisa</creatorcontrib><creatorcontrib>Sato, Takeo</creatorcontrib><creatorcontrib>Nishizawa, Nobuyuki</creatorcontrib><creatorcontrib>Tajima, Hiroshi</creatorcontrib><creatorcontrib>Kaizu, Takashi</creatorcontrib><creatorcontrib>Kato, Hiroshi</creatorcontrib><creatorcontrib>Sengoku, Norihiko</creatorcontrib><creatorcontrib>Tanaka, Kiyoshi</creatorcontrib><creatorcontrib>Naitoh, Takeshi</creatorcontrib><creatorcontrib>Kumamoto, Yusuke</creatorcontrib><creatorcontrib>Sangai, Takafumi</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Hiki, Naoki</creatorcontrib><title>Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Pancreas-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.
Methods
We 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).
Results
Postoperative 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].
Conclusions
Our 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.</description><subject>Abdominal Surgery</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pancreas</subject><subject>Postoperative period</subject><subject>Proctology</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kE1LxDAQhoMoun78AQ9S8OIlmknTtDnK4hcIelA8hphOly5tU5Pswv57o_UDPAiBMOTJOzMPIcfAzoGx8iIwJqSgjANllZJA5RaZgcg55RyqbTJjKmeUl0rskf0QlizxCopdspcLVQHP2Yy8PJrBejSBWjdEY2OHIWQLE6JHG12_yRrnp7q1mU0w-mz0uMYhhmx0IboRvYntGrN2aDrT96lwwyHZaUwX8OjrPiDP11dP81t6_3BzN7-8p1YIiNRagbxsamtUKdMKNRc2t3VRGQEclORSGmS8sAIYb9LWlUmnLOpXLBpAmR-Qsyl39O5thSHqvg0Wu84M6FZBcwlSAgNRJPT0D7p0Kz-k6RJVqVzxkpeJ4hNlvQvBY6NH3_bGbzQw_aFdT9p10q4_teuPKU6-olevPdY_X749JyCfgJCehgX6397_xL4DoKiOJw</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Ushiku, Hideki</creator><creator>Sakuraya, Mikiko</creator><creator>Washio, Marie</creator><creator>Hosoda, Kei</creator><creator>Niihara, Masahiro</creator><creator>Harada, Hiroki</creator><creator>Miura, Hirohisa</creator><creator>Sato, Takeo</creator><creator>Nishizawa, Nobuyuki</creator><creator>Tajima, Hiroshi</creator><creator>Kaizu, Takashi</creator><creator>Kato, Hiroshi</creator><creator>Sengoku, Norihiko</creator><creator>Tanaka, Kiyoshi</creator><creator>Naitoh, Takeshi</creator><creator>Kumamoto, Yusuke</creator><creator>Sangai, Takafumi</creator><creator>Yamashita, Keishi</creator><creator>Hiki, Naoki</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6857-8736</orcidid></search><sort><creationdate>20220801</creationdate><title>Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation</title><author>Ushiku, Hideki ; Sakuraya, Mikiko ; Washio, Marie ; Hosoda, Kei ; Niihara, Masahiro ; Harada, Hiroki ; Miura, Hirohisa ; Sato, Takeo ; Nishizawa, Nobuyuki ; Tajima, Hiroshi ; Kaizu, Takashi ; Kato, Hiroshi ; Sengoku, Norihiko ; Tanaka, Kiyoshi ; Naitoh, Takeshi ; Kumamoto, Yusuke ; Sangai, Takafumi ; Yamashita, Keishi ; Hiki, Naoki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-cc4e27fdca976961d24c3cd58a412196266ae025c4102f1008a08a75dbe5f1e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdominal Surgery</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pancreas</topic><topic>Postoperative period</topic><topic>Proctology</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ushiku, Hideki</creatorcontrib><creatorcontrib>Sakuraya, Mikiko</creatorcontrib><creatorcontrib>Washio, Marie</creatorcontrib><creatorcontrib>Hosoda, Kei</creatorcontrib><creatorcontrib>Niihara, Masahiro</creatorcontrib><creatorcontrib>Harada, Hiroki</creatorcontrib><creatorcontrib>Miura, Hirohisa</creatorcontrib><creatorcontrib>Sato, Takeo</creatorcontrib><creatorcontrib>Nishizawa, Nobuyuki</creatorcontrib><creatorcontrib>Tajima, Hiroshi</creatorcontrib><creatorcontrib>Kaizu, Takashi</creatorcontrib><creatorcontrib>Kato, Hiroshi</creatorcontrib><creatorcontrib>Sengoku, Norihiko</creatorcontrib><creatorcontrib>Tanaka, Kiyoshi</creatorcontrib><creatorcontrib>Naitoh, Takeshi</creatorcontrib><creatorcontrib>Kumamoto, Yusuke</creatorcontrib><creatorcontrib>Sangai, Takafumi</creatorcontrib><creatorcontrib>Yamashita, Keishi</creatorcontrib><creatorcontrib>Hiki, Naoki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ushiku, Hideki</au><au>Sakuraya, Mikiko</au><au>Washio, Marie</au><au>Hosoda, Kei</au><au>Niihara, Masahiro</au><au>Harada, Hiroki</au><au>Miura, Hirohisa</au><au>Sato, Takeo</au><au>Nishizawa, Nobuyuki</au><au>Tajima, Hiroshi</au><au>Kaizu, Takashi</au><au>Kato, Hiroshi</au><au>Sengoku, Norihiko</au><au>Tanaka, Kiyoshi</au><au>Naitoh, Takeshi</au><au>Kumamoto, Yusuke</au><au>Sangai, Takafumi</au><au>Yamashita, Keishi</au><au>Hiki, Naoki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2022-08-01</date><risdate>2022</risdate><volume>36</volume><issue>8</issue><spage>5644</spage><epage>5651</epage><pages>5644-5651</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Pancreas-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.
Methods
We 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).
Results
Postoperative 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].
Conclusions
Our 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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>34981230</pmid><doi>10.1007/s00464-021-08961-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6857-8736</orcidid></addata></record> |
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| subjects | Abdominal Surgery Gastric cancer Gastroenterology Gastrointestinal surgery Gynecology Hepatology Laparoscopy Medicine Medicine & Public Health Pancreas Postoperative period Proctology Surgery Surgical outcomes |
| title | Pancreas-contactless gastrectomy for gastric cancer prevents postoperative inflammation |
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