Asian journal of endoscopic surgery · 2025
Lateral Segment Thickness of the Liver Is a Risk Factor for Elevated Liver Enzymes After Laparoscopic Gastrectomy Using the Nathanson Liver Retractor.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Iida Michihisa, Watanabe Yusaku, Nakashima Chiyo, Nishiyama Mitsuo, Matsui Hiroto, Shindo Yoshitaro, Tokumitsu Yukio, Tomochika Shinobu, Nakagami Yuki, Takahashi Hidenori, Nagano Hiroaki
Аннотация
INTRODUCTION: Liver transaminase levels may be elevated following gastrectomy using the Nathanson liver retractor, which is widely used in laparoscopic gastrectomy. However, risk factors for developing liver dysfunction associated with this procedure remain unclear.
METHODS: Overall, 258 consecutive patients who underwent laparoscopic gastrectomy for gastric cancer using a Nathanson retractor between 2015 and 2022 were categorized into groups with and without Common Terminology Criteria for Adverse Event grade 3 or higher elevation in transaminases. Factors associated with transaminase elevation after laparoscopic gastrectomy were analyzed.
RESULTS: Grade 3 or higher transaminase elevation was observed in 62 (24.0%) patients. Male sex, preoperative transaminase elevation, fatty liver, high body mass index, thickness of the lateral segment of the liver, D2 lymph node dissection, long operative duration, and high amount of blood loss were significantly associated with elevated transaminase levels in the univariable analysis. In the multivariable analysis, lateral segment thickness of the liver and operative duration were independent risk factors for postoperative elevation in transaminase levels.
CONCLUSION: Lateral segment thickness of the liver and operative duration were independent risk factors for transaminase elevation after laparoscopic gastrectomy using a Nathanson retractor. Although it is an easy and useful liver retractor, alternative methods of liver elevation should be considered in patients at risk of elevated postoperative liver enzyme levels.
METHODS: Overall, 258 consecutive patients who underwent laparoscopic gastrectomy for gastric cancer using a Nathanson retractor between 2015 and 2022 were categorized into groups with and without Common Terminology Criteria for Adverse Event grade 3 or higher elevation in transaminases. Factors associated with transaminase elevation after laparoscopic gastrectomy were analyzed.
RESULTS: Grade 3 or higher transaminase elevation was observed in 62 (24.0%) patients. Male sex, preoperative transaminase elevation, fatty liver, high body mass index, thickness of the lateral segment of the liver, D2 lymph node dissection, long operative duration, and high amount of blood loss were significantly associated with elevated transaminase levels in the univariable analysis. In the multivariable analysis, lateral segment thickness of the liver and operative duration were independent risk factors for postoperative elevation in transaminase levels.
CONCLUSION: Lateral segment thickness of the liver and operative duration were independent risk factors for transaminase elevation after laparoscopic gastrectomy using a Nathanson retractor. Although it is an easy and useful liver retractor, alternative methods of liver elevation should be considered in patients at risk of elevated postoperative liver enzyme levels.