Dataset Information

The impact of pancreas compression time during minimally invasive gastrectomy on the postoperative complications in gastric cancer

ABSTRACT: Abstract

Aim

Pancreas compression during minimally invasive gastrectomy causes blunt injury to the pancreas and leads to postoperative complications. However, the extent of practical compression associated with the incidence of postoperative complications remains unknown. This study aimed to evaluate the impact of pancreas compression, particularly the duration of compression, on short‐term outcomes in minimally invasive gastrectomy for gastric cancer.

Methods

This study included 178 patients who underwent laparoscopic or robotic gastrectomy at the Shizuoka Cancer Center in 2018. The total time of pancreas compression during gastrectomy was measured using video‐reviews, and the correlation between the time and surgical outcomes was evaluated.

Results

A duration of 3 min was selected as the cutoff value of pancreas compression time to predict high drain amylase concentration on postoperative day 1 (≥1000 U/L). The incidence of clinically relevant pancreatic fistula (1.5% vs 12.4%, P = .011) and all postoperative complications (12.3% vs 30.1%, P = .010) were significantly higher in the longer‐compression group than in the shorter‐compression group. The multivariable analysis identified longer compression as the only independent risk factor for postoperative complications.

Conclusion

More than a few minutes of pancreas compression during minimally invasive gastrectomy was associated with a higher incidence of postoperative complications. This retrospective study aimed to clarify the influence of pancreas compression, with special attention on the duration of compression on the short‐term outcomes in patients who received minimally invasive gastrectomy. We assessed 178 patients who underwent laparoscopic or robotic gastrectomy at the Shizuoka Cancer Center in 2018. The cutoff value of pancreas compression time for the prediction of blunt injury of pancreas was found to be 3 min, and the incidence of postoperative complications was significantly higher in patients with longer‐compression than in those with shorter‐compression.

SUBMITTER: Itamoto K

PROVIDER: S-EPMC8560619 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeExercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy.Materials and methodsTwenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery).ResultsOf the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P<0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P<0.05).ConclusionsIn gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov NCT01751880).