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

Authors
Park, Shin-HooBae, Seong-WooJeong, Kyoung-YunKoo, Eun-HeeChoi, Jong-HoPark, Ji-HyeonKong, Seong-HoChoi, Won-SilPark, Do JoongLee, Hyuk-JoonYang, Han-Kwang
Issue Date
Aug-2022
Publisher
Springer Verlag
Keywords
Lipid; Droplet; Gastric cancer; Fatty acid; Laparoscopic lymphadenectomy
Citation
Surgical Endoscopy, v.36, no.8, pp.6095 - 6104
Indexed
SCIE
SCOPUS
Journal Title
Surgical Endoscopy
Volume
36
Number
8
Start Page
6095
End Page
6104
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55543
DOI
10.1007/s00464-022-09173-2
ISSN
0930-2794
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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Park, Shin-Hoo
Anam Hospital (Department of Foregut Surgery, Anam Hospital)
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