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Published in: Surgical Endoscopy 8/2022

21-03-2022 | Gastrectomy

Clinical significance of lipid droplets formed in the peritoneal fluid after laparoscopic surgery for gastric cancer

Authors: 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

Published in: Surgical Endoscopy | Issue 8/2022

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Abstract

Background

Several 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.

Methods

This 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.

Results

In 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).

Conclusions

The 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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Metadata
Title
Clinical significance of lipid droplets formed in the peritoneal fluid after laparoscopic surgery for gastric cancer
Authors
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
Publication date
21-03-2022
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-022-09173-2

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