Shin-Hoo Park1,2,3, Seong-Woo Bae1,4, Kyoung-Yun Jeong1,4, Eun-Hee Koo1,4, Jong-Ho Choi2, Ji-Hyeon Park2, Seong-Ho Kong1,2, Won-Sil Choi5, Do Joong Park1,2,4, Hyuk-Joon Lee1,2,4, Han-Kwang Yang6,7,8. 1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Surgery, Seoul National University Hospital, 101 Daehark-ro, Jongno-gu, Seoul, 03080, Korea. 3. Division of Foregut Surgery, Korea University College of Medicine, Seoul, Republic of Korea. 4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 5. National Instrumentation Center for Environmental Management, Seoul National University, Seoul, Korea. 6. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. hkyang@snu.ac.kr. 7. Department of Surgery, Seoul National University Hospital, 101 Daehark-ro, Jongno-gu, Seoul, 03080, Korea. hkyang@snu.ac.kr. 8. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. hkyang@snu.ac.kr.
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.
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.
Authors: Hyuk-Joon Lee; Woo Jin Hyung; Han-Kwang Yang; Sang Uk Han; Young-Kyu Park; Ji Yeong An; Wook Kim; Hyoung-Il Kim; Hyung-Ho Kim; Seung Wan Ryu; Hoon Hur; Seong-Ho Kong; Gyu Seok Cho; Jin-Jo Kim; Do Joong Park; Keun Won Ryu; Young Woo Kim; Jong Won Kim; Joo-Ho Lee; Min-Chan Kim Journal: Ann Surg Date: 2019-12 Impact factor: 12.969
Authors: Lucy M Browning; Celia G Walker; Adrian P Mander; Annette L West; Jackie Madden; Joanna M Gambell; Stephen Young; Laura Wang; Susan A Jebb; Philip C Calder Journal: Am J Clin Nutr Date: 2012-08-29 Impact factor: 7.045