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The effect and clinical significance of using nathanson liver retractor on liver function tests in laparoscopic gastric cancer surgery

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Gojayev A., Yüksel C., Mercan Ü., Çaparlar M. A., Çetindağ Ö., Akbulut S., Ünal A. E., Bayar S., Demirci S.

Polish Journal of Surgery

2021

vol. 94

issue 1

1-7

Aim: There are very few studies in the literature investigating the changes caused by the Nathanson retractors in liver function tests (LFT) after LG and their clinical significance. The present study investigated the changes made by the Nathanson retractor used during laparoscopic gastrectomy (LG) in LFT and their clinical significance. Material and methods: The data of 236 patients who underwent radical gastrectomy for primary gastric cancer at Surgical Oncology Unit in the period between January 2015 and January 2020 were retrospectively studied. The patients were divided into two groups: laparoscopic gastrectomy (LG; 136 cases) and open gastrectomy (OG; 106 cases). Patients after cholecystectomy, with primary or secondary liver tumors, with chronic hepatic disease, with high preoperative ALT, AST and bilirubin values were excluded from the study. LFT were measured preoperatively and on postoperative day 1 (LFT1), LFT3, LFT5 and LFT7. LFT: ALT, AST and Total bilirubin (BIL). Results: ALT1, ALT3, ALT5, ALT7 ALT values and AST1, AST3, AST5 AST values of patients in the LG group were found to be significantly higher (P < 0.001). Mean total bilirubin values of the groups were similar (P > 0.05). In order to evaluate how the increase in LFT due to the use of the Nathanson retractors reflected on the patients' clinic, we divided the patients who underwent LG into two groups based on ALT increase in ALT1: Normal and Elevated. The in-hospital mortality rates (P = 0.080) and oral nutrition time (P = 0.913) of the groups were similar. No liver infarction developed in any of the groups. The duration of stay in the ICU was significantly longer in individuals with elevated LFT (P = 0.019). Conclusion: Although the use of the Nathanson retractor during LG causes an increase in liver function test results, this does not cause major clinical problems in patients

Znaczenie laparoskopowej oceny zaawansowania w leczeniu raka żołądka

100%

Yüksel C., Erşen O., basceken s. i., mercan ü., yalkın ö., Culcu S., Bakırarar B., Bayar S., Ünal A. E., Demirci S.

Polish Journal of Surgery

2021

vol. 93

issue 2

1-8

Cel: Laparoskopia z oceną zaawansowania (ang. staging laparoscopy; SL) pozwala na wdrożenie leczenia paliatywnego, terapii neoadjuwantowej przed leczeniem operacyjnym lub na bezpośrednią resekcję radykalną oraz na ustalenie strategii postępowania, co pozwala ograniczyć śmiertelność poprzez uniknięcie niepotrzebnych laparotomii. W naszym badaniu retrospektywnie oceniliśmy znaczenie laparoskopii z oceną zaawansowania w oparciu o dane kliniczne i histopatologiczne. Metody : Analizie retrospektywnej poddano dane 70 z 350 pacjentów poddawanych diagnostycznej laparoskopii z powodu raka żołądka w Klinice Chirurgii Onkologicznej od sierpnia 2013 do stycznia 2020 roku. Wyniki: Biopsja otrzewnej była dodatnia na obecność komórek nowotworowych u 41 (58,5%) pacjentów i ujemna u 29 (41,5%) pacjentów poddawanych SL. Cytologia płynu z otrzewnej była ujemna u 32 (45,7%) pacjentów i dodatnia u 38 (54,3%) pacjentów. Wyniki biopsji i cytologii były równocześnie dodatnie u 35 pacjentów i jednocześnie ujemne u 26 pacjentów. Wnioski: Podsumowując, nawet najbardziej zaawansowane metody obrazowania nie pozawalają w 100% ocenić zaawansowania procesu nowotworowego, tym samym SL odgrywa istotną rolę w leczeniu pacjentów z rakiem żołądka. Laparoskopowa ocena zaawansowania, jako zabieg prosty, tani, bezpieczny i dobrze tolerowany, powinna stanowić podstawę postępowania u pacjentów z podejrzeniem zajęcia otrzewnej, u których nie udaje się w pełni ocenić zaawansowania choroby badaniami przedoperacyjnymi.

The role of laparoscopic staging for the management of gastric cancer

100%

Yüksel C., Erşen O., basceken s. i., mercan ü., yalkın ö., Culcu S., Bakırarar B., Bayar S., Ünal A. E., Demirci S.

Polish Journal of Surgery

2021

vol. 93

issue 2

1-8

AİM Staging laparoscopy enables us to perform palliative treatment, neo-adjuvant therapy for curative resection or direct curative resection and making a decision with minimal morbidity by avoiding from unnecessary laparotomies. In the present study, the importance of staging lapafoscopy was retrospectively investigated by using clinical and pathologic data. METHODS Data of 70 out of 350 patients who underwent diagnostic laparoscopy due to gastric cancer at Surgical Oncology department between August 2013 and January 2020 were retrospectively analyzed. RESULTS Peritoneal biopsy was positive for malignity in 41 (58.5%) and negative in 29 (41.5%) of the patients who underwent SL. Peritoneal cytology (PC) results were negative in 32 (45.7%) patients and positive in 38 (54.3%) patients. Peritoneal biopsy and cytology results were concurrently positive in 35 patients and concurrently negative in 26 patients. CONCLUSİONS In conclusion, even the most developed imaging methods cannot provide 100% staging, therefore SL plays an important role in treatment of gastric cancer and laparoscopic staging is essential as a simple, inexpensive, safe and well tolerated method in patients who have the suspicion of peritoneal disease and who cannot be clearly evaluated with pre-operative methods.

Refine search results

3 Polish Journal of Surgery

3 2021

3 Bayar S.

3 Demirci S.

3 Yüksel C.

3 Ünal A. E.

2 Bakırarar B.

2 Culcu S.

2 Erşen O.

2 basceken s. i.

2 mercan ü.

2 yalkın ö.

1 Akbulut S.

1 Gojayev A.

1 Mercan Ü.

1 Çaparlar M. A.

1 Çetindağ Ö.

Search results

The effect and clinical significance of using nathanson liver retractor on liver function tests in laparoscopic gastric cancer surgery

Znaczenie laparoskopowej oceny zaawansowania w leczeniu raka żołądka

The role of laparoscopic staging for the management of gastric cancer