Comparative Analysis of Immediate Postoperative Complications Following Total Gastrectomy

Stancu, Samantha Mc Kenzie; Popescu, Bogdan A

doi:10.5604/01.3001.0010.1048

Cited by 2 publications

(4 citation statements)

References 13 publications

(24 reference statements)

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“…Different surgical techniques have various local and general imbroglios [ 6 ]. One of the most important problems in the treatment of patients suffering from stomach cancer is their proper preoperative preparation.…”

Section: Discussionmentioning

confidence: 99%

“…Despite progress in diagnostic and therapeutic management, therapy of invasive gastric cancer is associated with a high morbidity and mortality rate, as well as a low quality of life. Postoperative complication rates after total gastrectomy range from 9 to 47.5% and reported mortality rates vary between 1.1 and 10.8% [ 3 , 4 , 5 , 6 ]. The most important causes of poor post-operative outcomes are late diagnosis, tumour-related cachexia, and decreased food intake due to anorexia with various secondary causes such as xerostomia, nausea, vomiting, malabsorption, reduced intestinal motility, abdominal pain, chemosensory alteration leading to pre-operative malnutrition in as many as 85% cases [ 7 ], and impaired host immune system [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes

Kamocki,

Matowicka-Karna,

Jurczuk

et al. 2023

Nutrients

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Background: The aim of this study was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity, and early postoperative outcomes. Methods: Patients suffering from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine, and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss, and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets, and their phagocytic ability were measured twice. Postsurgical complications were assessed via the Clavien–Dindo classification. Results: Group I consisted of 20 patients with an oral glutamine—10 g daily. Group II had 38 patients who received intravenous glutamine, 1.5 mL per kg body weight of Dipeptiven. Group III consisted of 25 patients who did not receive preoperative immunonutrition. In total, 47% of patients in Group I, 54% of patients in Group II, and 33% of patients in Group III were malnourished. In Group I, the percentage of phagocytizing platelet (%PhP) was 1.1 preoperatively and 1.2 postoperatively. The phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2 and PhI was 1.0 and 1.1. In Group III, the %PhP was 1.0 and 1.2 and PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a decline in total protein and albumin level in Group II. In Group III, there was a decline in total protein, albumin, and cholesterol level. The total platelet count and PhI were increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III, there was a rise in blood platelet level, %PhP, and PhI. The complication rates were 53% in Group I, 29% in Group II, and 40% in Group III. Conclusions: In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 44.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters; however, this did not affect the reduction in the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. The administered preoperative parenteral nutrition and the surgical procedure itself influenced the improvement of the phagocytic activity of blood platelets. Glutamine did not have this effect, regardless of the route of administration.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes

Kamocki,

Matowicka-Karna,

Jurczuk

et al. 2023

Nutrients

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show abstract

“…Different surgical techniques have various local and general imbroglios [6]. of patients with gastric cancer [16].…”

Section: Grade Group I Group Iimentioning

confidence: 99%

“…and often low quality of life. Postoperative complication rate after total gastrectomy ranges from 9 to 47.5% and reported mortality rate varies between 1.1 and 10.8% [3][4][5][6]. Causes of poor outcomes are late diagnosis, pre-operative malnutrition and impaired immune system being one of the most important causes.…”

Section: Introductionmentioning

confidence: 99%

Impact of preoperative immunonutrition on thrombocyte phagocytic activity and early postoperative outcomes in invasive gastric cancer patients.

Kamocki

Matowicka

Jurczuk

et al. 2020

Preprint

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Background:The aim was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity and early postoperative outcomes. Methods:Patients suffer from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets and their phagocytic ability were measured twice. Postsurgical complications were assessed via Claven-Dindo classification. Results:Group I-20 patients with an oral glutamine, Group II-38 patients received an intravenous glutamine. Group III-25 patients did not receive preoperative immunonutrition. 47% patients Group I, 54% patients Group II and 33% patients Group III were malnourished. In Group I, percentage of phagocytizing platelet (%PhP) was 1.1 pre- and 1.2 postoperatively. Phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2. PhI was 1.0 and 1.1. In Group III %PhP was 1.0 and1.2. PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a fall in total protein, albumin level in Group II. In Group III there was a decline in total protein, albumin and cholesterol level. Total platelet count, and PhI was increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III there was no change in blood plateles level, %PhP and PhI. Complications rate was 53% in Group I, 29 % in Group II, 40% in Group III. Conclusions:In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 45.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters, however, this did not affect the reduction of the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. Immunonutrition based on intravenous form of glutamine allows to improve the phagocytic activity of platelets.

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Comparative Analysis of Immediate Postoperative Complications Following Total Gastrectomy

Cited by 2 publications

References 13 publications

Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes

Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes

Impact of preoperative immunonutrition on thrombocyte phagocytic activity and early postoperative outcomes in invasive gastric cancer patients.

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