Research Article
Mide kanser cerrahisi sonrası dren sıvısındaki yüksek amilaz değerinin etkisi: Bu bir komplikasyon mu yoksa sadece şüpheli biyokimyasal bir ölçüm mü?
Abstract
Amaç: Pankreatik fistülün, olası bir postoperatif
komplikasyon olarak, değişkenlik gösteren tanım, görülme sıklığı ve risk
faktörleri vardır. Bu çalışmada, mide cerrahisi sonrası pankreatik
fistülün etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Mide adenokarsinomu için tedavi edici amaçlı lenfadenektomi ile açık
gastrektomi uygulanan toplam 28 ardışık hasta retrospektif olarak
incelendi. Hastaların demografik, peri-operatif ve patolojik verileri
toplandı. Uluslararası Pankreatik Fistül Sistemi çalışma grubuna göre
teşhis ve derecelendirilen pankreas fistülü ana değişken olarak tanımlandı.
Bulgular: Hastaların yaş ortalaması 58,8 ± 10,1yıl idi ve kadın / erkek oranı 9
/ 19'du. Altı hastada (% 21.4) grade A pankreatik fistül
saptandı. Grade B ve C pankreatik fistül yoktu. Dren amilaz düzeyi
pankreas fistülü olan hastalarda anlamlı olarak daha yüksekti (p =
0,0001). Fistüllü ve fistülsüz hastalarda drenaj miktarı, hastanede kalış
süresi ve dren süreleri açısından anlamlı fark yoktu. Fistül gelişimi ile hastaların demografik özellikleri, peri-operatif ve
patolojik veriler arasında anlamlı ilişki bulunmadı.
Sonuç: Mide cerrahisi sonrası grade A pankreatik fistül gelişimi klinik
sonuçları olan majör bir komplikasyon olarak görünmemektedir. Dren
sıvısındaki yüksek amilaz seviyesi, sadece biyokimyasal bir ölçü olarak
düşünülebilir.
References
- 1- Seo HS, Shim JH, Jeon HM, Park CH, Song KY. Postoperative pancreatic fistula after robot distal gastrectomy. J Surg Res. 2015;194:361-6.
- 2- Yu HW, Jung DH, Son SY, Lee CM, Lee JH, Ahn SH, et al. Risk factors of postoperative pancreatic fistula in curative gastric cancer surgery. J Gastric Cancer. 2013;13:179-84.
- 3- De Sol A, Cirocchi R, Di Patrizi MS, Boccolini A, Barillaro I, Cacurri A, et al. The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis. World J Surg Oncol. 2015;13:65.
- 4- Kobayashi D, Iwata N, Tanaka C, Kanda M, Yamada S, Nakayama G, et al. Factors related to occurrence and aggravation of pancreatic fistula after radical gastrectomy for gastric cancer. J Surg Oncol. 2015;112:381-6.
- 5- Kung CH, Lindblad M, Nilsson M, Rouvelas I, Kumagai K, Lundell L, et al. Postoperative pancreatic fistula formation according to ISGPF criteria after D2 gastrectomy in Western patients. Gastric Cancer. 2014, 17:571-7.
- 6- Hiura Y, Takiguchi S, Yamamoto K, Kurokawa Y, Yamasaki M, Nakajima K, et al. Use of fibrin glue sealant with polyglycolic acid sheets to prevent pancreatic fistula formation after laparoscopic-assisted gastrectomy. Surg Today. 2013;43:527-33.
- 7- Komatsu S, Ichikawa D, Kashimoto K, Kubota T, Okamoto K, Konishi H, et al. Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer. World J Gastroenterol. 2013;19:8696-702.
- 8- Bonenkamp JJ, Songun I, Hermans J, Sasako M, Welvaart K, Plukker JT, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet. 1995;345:745-8.
- 9- Nobuoka D, Gotohda N, Konishi M, Nakagohri T, Takahashi S, Kinoshita T. Prevention of postoperative pancreatic fistula after total gastrectomy. World J Surg. 2008;32:2261-6.
- 10- Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017;161:584-91.
- 11- Miyai H, Hara M, Hayakawa T, Takeyama H. Establishment of a simple predictive scoring system for pancreatic fistula after laparoscopy-assisted gastrectomy. Dig Endosc. 2013;25:585-92.
- 12- Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101-12.
- 13- Yamamoto N, Oshima T, Sato T, Makino H, Nagano Y, Fujii S, et al. Upper abdominal body shape is the risk factor for postoperative pancreatic fistula after splenectomy for advanced gastric cancer: a retrospective study. World J Surg Oncol. 2008;6:109.
- 14- Kodera Y, Sasako M, Yamamoto S, Sano T, Nashimoto A, Kurita A. Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer. Br J Surg. 2005;92:1103-9.
- 15- Miki Y, Tokunaga M, Bando E, Tanizawa Y, Kawamura T, Terashima M. Evaluation of postoperative pancreatic fistula after total gastrectomy with D2 lymphadenectomy by ISGPF classification. J Gastrointest Surg. 2011,15:1969-76.
- 16- Nakauchi M, Suda K, Kadoya S, Inaba K, Ishida Y, Uyama I. Technical aspects and short- and long-term outcomes of totally laparoscopic total gastrectomy for advanced gastric cancer: a single-institution retrospective study. Surg Endosc. 2016;30:4632-9.
- 17- Sasako M, Katai H, Sano T, Maruyama K. Management of complications after gastrectomy with extended lymphadenectomy. Surg Oncol. 2000;9:31-4.
- 18- Jiang X, Hiki N, Nunobe S, Kumagai K, Nohara K, Sano T, et al. Postoperative pancreatic fistula and the risk factors of laparoscopy-assisted distal gastrectomy for early gastric cancer. Ann Surg Oncol. 2012;19:115-21.
- 19- Jiang L, Yang KH, Chen Y, Guan QL, Zhao P, Tian JH, et al. Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer. Br J Surg. 2014;101:595-604.
- 20- Taniguchi Y, Kurokawa Y, Mikami J, Tanaka K, Miyazaki Y, Makino T, et al. Amylase concentration in drainage fluid as a predictive factor for severe postoperative pancreatic fistula in patients with gastric cancer. Surg Today. 2017;47:1378-83.
- 21- Matsunaga T, Saito H, Murakami Y, Kuroda H, Fukumoto Y, Osaki T. Serum level of C-reactive protein on postoperative day 3 is a predictive indicator of postoperative pancreatic fistula after laparoscopic gastrectomy for gastric cancer. Asian J Endosc Surg. 2017;10:382-7.
- 22- Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8-13.
- 23- Hasbahceci M, Mehdi E, Malya FU, Kunduz E, MemmI N, YIgman S, et al. Role of obesity and abdominal shape morphometric features to predict postoperative complications and quality of lymph node dissection of gastrectomy for gastric cancer. Neoplasma. 2017;64:922-32.
- 24- Katai H, Yoshimura K, Fukagawa T, Sano T, Sasako M. Risk factors for pancreas-related abscess after total gastrectomy. Gastric Cancer. 2005;8:137-41.
- 25- Tomimaru Y, Miyashiro I, Kishi K, Motoori M, Yano M, Shingai T, et al. Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer? J Surg Oncol. 2011,104:274-7.
- 26- Imamura H, Kurokawa Y, Kawada J, Tsujinaka T, Takiguchi S, Fujiwara Y, et al. Influence of bursectomy on operative morbidity and mortality after radical gastrectomy for gastric cancer: results of a randomized controlled trial. World J Surg. 2011;35:625-30.
Impact of high amylase level in drainage fluid after gastric cancer surgery: Is it a complication or suspicious biochemical measurement?
Abstract
Purpose: Pancreatic fistula is a
potential postoperative complication with variable definitions, incidences and
risk factors. We intended to evaluate its impact after gastric surgery.
Materials and Methods: A total of 28 consecutive patients
who underwent curative open gastrectomy with lymphadenectomy for gastric
adenocarcinoma were retrospectively analyzed. Patients’ demographics,
peri-operative and pathological data were collected. Pancreatic fistula that
was diagnosed and graded according to International Study Group of Pancreatic
Fistula’s system was identified as main variable.
Results: Mean age of
patients was 58.8±10.1 years with a female to male ratio of 9/19. Grade
A pancreatic fistula was diagnosed in six patients (21.4%). There was no grade B and C pancreatic
fistula. Drain amylase level was significantly higher in patients with
pancreatic fistula (p=0.0001). There was no significant difference with regard
to amount of drainage, length of hospital stay and duration of drains in
patients with and without fistula. No significant association was shown between
development of fistula and patients’ demographics, peri-operative and
pathological data.
Conclusion: The development of grade A
pancreatic fistula after gastric surgery does not appear to be a major
complication with clinical consequences. High amylase level in the drainage
fluid can be considered as a biochemical measure only.
References
- 1- Seo HS, Shim JH, Jeon HM, Park CH, Song KY. Postoperative pancreatic fistula after robot distal gastrectomy. J Surg Res. 2015;194:361-6.
- 2- Yu HW, Jung DH, Son SY, Lee CM, Lee JH, Ahn SH, et al. Risk factors of postoperative pancreatic fistula in curative gastric cancer surgery. J Gastric Cancer. 2013;13:179-84.
- 3- De Sol A, Cirocchi R, Di Patrizi MS, Boccolini A, Barillaro I, Cacurri A, et al. The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis. World J Surg Oncol. 2015;13:65.
- 4- Kobayashi D, Iwata N, Tanaka C, Kanda M, Yamada S, Nakayama G, et al. Factors related to occurrence and aggravation of pancreatic fistula after radical gastrectomy for gastric cancer. J Surg Oncol. 2015;112:381-6.
- 5- Kung CH, Lindblad M, Nilsson M, Rouvelas I, Kumagai K, Lundell L, et al. Postoperative pancreatic fistula formation according to ISGPF criteria after D2 gastrectomy in Western patients. Gastric Cancer. 2014, 17:571-7.
- 6- Hiura Y, Takiguchi S, Yamamoto K, Kurokawa Y, Yamasaki M, Nakajima K, et al. Use of fibrin glue sealant with polyglycolic acid sheets to prevent pancreatic fistula formation after laparoscopic-assisted gastrectomy. Surg Today. 2013;43:527-33.
- 7- Komatsu S, Ichikawa D, Kashimoto K, Kubota T, Okamoto K, Konishi H, et al. Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer. World J Gastroenterol. 2013;19:8696-702.
- 8- Bonenkamp JJ, Songun I, Hermans J, Sasako M, Welvaart K, Plukker JT, et al. Randomised comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet. 1995;345:745-8.
- 9- Nobuoka D, Gotohda N, Konishi M, Nakagohri T, Takahashi S, Kinoshita T. Prevention of postoperative pancreatic fistula after total gastrectomy. World J Surg. 2008;32:2261-6.
- 10- Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017;161:584-91.
- 11- Miyai H, Hara M, Hayakawa T, Takeyama H. Establishment of a simple predictive scoring system for pancreatic fistula after laparoscopy-assisted gastrectomy. Dig Endosc. 2013;25:585-92.
- 12- Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101-12.
- 13- Yamamoto N, Oshima T, Sato T, Makino H, Nagano Y, Fujii S, et al. Upper abdominal body shape is the risk factor for postoperative pancreatic fistula after splenectomy for advanced gastric cancer: a retrospective study. World J Surg Oncol. 2008;6:109.
- 14- Kodera Y, Sasako M, Yamamoto S, Sano T, Nashimoto A, Kurita A. Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group. Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer. Br J Surg. 2005;92:1103-9.
- 15- Miki Y, Tokunaga M, Bando E, Tanizawa Y, Kawamura T, Terashima M. Evaluation of postoperative pancreatic fistula after total gastrectomy with D2 lymphadenectomy by ISGPF classification. J Gastrointest Surg. 2011,15:1969-76.
- 16- Nakauchi M, Suda K, Kadoya S, Inaba K, Ishida Y, Uyama I. Technical aspects and short- and long-term outcomes of totally laparoscopic total gastrectomy for advanced gastric cancer: a single-institution retrospective study. Surg Endosc. 2016;30:4632-9.
- 17- Sasako M, Katai H, Sano T, Maruyama K. Management of complications after gastrectomy with extended lymphadenectomy. Surg Oncol. 2000;9:31-4.
- 18- Jiang X, Hiki N, Nunobe S, Kumagai K, Nohara K, Sano T, et al. Postoperative pancreatic fistula and the risk factors of laparoscopy-assisted distal gastrectomy for early gastric cancer. Ann Surg Oncol. 2012;19:115-21.
- 19- Jiang L, Yang KH, Chen Y, Guan QL, Zhao P, Tian JH, et al. Systematic review and meta-analysis of the effectiveness and safety of extended lymphadenectomy in patients with resectable gastric cancer. Br J Surg. 2014;101:595-604.
- 20- Taniguchi Y, Kurokawa Y, Mikami J, Tanaka K, Miyazaki Y, Makino T, et al. Amylase concentration in drainage fluid as a predictive factor for severe postoperative pancreatic fistula in patients with gastric cancer. Surg Today. 2017;47:1378-83.
- 21- Matsunaga T, Saito H, Murakami Y, Kuroda H, Fukumoto Y, Osaki T. Serum level of C-reactive protein on postoperative day 3 is a predictive indicator of postoperative pancreatic fistula after laparoscopic gastrectomy for gastric cancer. Asian J Endosc Surg. 2017;10:382-7.
- 22- Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8-13.
- 23- Hasbahceci M, Mehdi E, Malya FU, Kunduz E, MemmI N, YIgman S, et al. Role of obesity and abdominal shape morphometric features to predict postoperative complications and quality of lymph node dissection of gastrectomy for gastric cancer. Neoplasma. 2017;64:922-32.
- 24- Katai H, Yoshimura K, Fukagawa T, Sano T, Sasako M. Risk factors for pancreas-related abscess after total gastrectomy. Gastric Cancer. 2005;8:137-41.
- 25- Tomimaru Y, Miyashiro I, Kishi K, Motoori M, Yano M, Shingai T, et al. Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer? J Surg Oncol. 2011,104:274-7.
- 26- Imamura H, Kurokawa Y, Kawada J, Tsujinaka T, Takiguchi S, Fujiwara Y, et al. Influence of bursectomy on operative morbidity and mortality after radical gastrectomy for gastric cancer: results of a randomized controlled trial. World J Surg. 2011;35:625-30.
There are 26 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research |
| Authors | |
| Publication Date | June 30, 2019 |
| Acceptance Date | November 21, 2018 |
| Published in Issue | Year 2019 Volume: 44 Issue: 2 |
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