医学
腹部外科
腹腔镜手术
解剖(医学)
胃切除术
临床意义
癌症
淋巴结切除术
外科
腹膜液
生理盐水
腹腔镜检查
胃肠病学
内科学
作者
Shin-Hoo Park,Seong-Woo Bae,Kyoung-Yun Jeong,Eun-Hee Koo,Jong-Ho Choi,Ji-Hyeon Park,Seong-Ho Kong,Won-Sil Choi,Do Joong Park,Hyuk-Joon Lee,Han-Kwang Yang
标识
DOI:10.1007/s00464-022-09173-2
摘要
BackgroundSeveral studies have previously reported that laparoscopic surgery using an energy sealing device generates hazardous surgical smoke. However, the droplets appearing on the surface of peritoneal fluid irrigated with saline, after dissection phase of laparoscopic gastrectomy were ignored for a long time. This study aimed to investigate the composition and clinical significance of these droplet particles.MethodsThis study prospectively enrolled 15 patients with early gastric cancer (cT1NanyM0) who were scheduled for laparoscopic gastrectomy. Floating phases of peritoneal irrigation fluid containing droplets in dissected area were retrieved before and after surgical dissection. Using gas chromatography analysis, the areas under the peak were compared between the samples retrieved before and after surgical dissection. We also analyzed if the area value with significant change was related to the inflammatory response.ResultsIn gas chromatography, the area values after laparoscopic surgical dissection were significantly increased in 10 out of 37 kinds of fatty acids, compared to those before surgical dissection. The significant increase in area value of α-linoleic and eicosadienoic acids were positively correlated with the elevated level of C-reactive protein at postoperative day 2 (Spearman’s ρ = 0.843, P < 0.001; Spearman’s ρ = 0.785, P = 0.001).ConclusionsThe lipid droplets, generated after laparoscopic lymphadenectomy during gastric cancer surgery, contained various types of fatty acids, and some of them have been found to be associated with inflammatory response.
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