RESUMEN
OBJECTIVE: We would like to investigate the prognostic utility of the previously described factors and offer a new parameter called neutrophil-to-C-reactive protein ratio (NCR) as a predictor of post-operative complications of pancreas cancer. METHODS: 92 patients underwent pancreaticoduodenectomy for the pancreatic head tumor were enrolled in this study. Receiver operating curve analysis was performed to detect the cutoff values, and logistic regression analyses were performed to identify the independent risk factors of complications. RESULTS: In univariate analysis, complications were observed in lymphocyte-to-C-reactive protein ratio levels below 0.06 (Odds Ratio [OR]: 3.92, 95% confidence interval [CI] = 1.08-14.21, p = 0.037). In multivariate analysis, albumin < 3.6 (OR: 3.25, 95% CI: 1.16-9.06, p = 0.024) and NCR < 0.28 (OR: 2.81, 95 % CI: 1.07-7.63, p = 0.042) were the independent and significant predictors of the overall survival. DISCUSSION: Quantification of preoperative NCR and albumin may help surgeons to settle an effective perioperative management, take extra caution, and be aware of post-operative complications of pancreatic cancer patients.
OBJETIVO: Se investigó la proporción de neutrófilos a proteína C reactiva (NCR) como predictor de complicaciones posoperatorias del cáncer de páncreas. MATERIAL Y MÉTODOS: 92 pacientes fueron sometidos a pancreaticoduodenectomía (PD) por el tumor de la cabeza del páncreas incluidos en este estudio. Se realizaron análisis de curva operativa del receptor (ROC) y análisis de regresión logística para detectar los valores de corte y los factores de riesgo independientes de complicaciones. RESULTADOS: En análisis univariado; se observaron complicaciones en niveles de LCR por debajo de 0,06 (OR: 3.92, IC 95%: 1.08-14.21, p = 0.037). En análisis multivariado; albúmina < 3.6 (OR: 3.25, IC 95 %: 1.16-9.06, p = 0.024), NCR < 0.28 (OR: 2.81, IC 95 %: 1.07-7.63, p = 0.042) fueron los predictores independientes y significativos de la supervivencia. CONCLUSIÓN: La cuantificación de la NCR y la albúmina preoperatorias puede ayudar a los cirujanos a establecer un manejo perioperatorio efectivo, tomar precauciones adicionales y estar atentos a las complicaciones posoperatorias.
Asunto(s)
Proteína C-Reactiva , Neutrófilos , Neoplasias Pancreáticas , Pancreaticoduodenectomía , Complicaciones Posoperatorias , Humanos , Neoplasias Pancreáticas/cirugía , Neoplasias Pancreáticas/sangre , Masculino , Femenino , Proteína C-Reactiva/análisis , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/epidemiología , Persona de Mediana Edad , Anciano , Pancreaticoduodenectomía/efectos adversos , Pronóstico , Estudios Retrospectivos , Recuento de Leucocitos , Albúmina Sérica/análisis , Adulto , Anciano de 80 o más Años , Factores de Riesgo , Curva ROCRESUMEN
Objectives: Hyoscine-N-butylbromide is used by some surgeons during laparoscopic sleeve gastrectomy (LSG) to loosen gastric smooth muscles and to provide a more effective LSG. However, evidence-based data on the effects of hyoscine-N-butylbromide in laparoscopic sleeve gastrectomy are limited and its effect on sleeve gastrectomy surgery and weight loss is unknown. The aim of this study was to analyze the effect of intraoperatively administered hyoscine-N-butylbromide on stomach resection volume, weight loss and complications seen in patients undergoing LSG. Material and Methods: Patients who underwent laparoscopic sleeve gastrectomy due to morbid obesity were included in the study. Intraoperative hyoscine-N-butylbromide was administered to 52 patients (Group 1), not applied to the other 52 patients (Group 2). Age, sex, height, weight and body mass index (BMI) data of the patients were obtained retrospectively. The weight, BMI, percentage of total weight loss (TWL%) and percentage of excess weight loss (EWL%) of the patients were evaluated at postoperative third, sixth and 12th months. Results: Resected gastric volume (p= 0.111), length of stapler line (p= 0.944), operation time (p= 0.383), hospitalization time (p= 0.494) and postoperative complications (p> 0.05) did not differ between Groups 1 and 2. However, frequency of intraoperative tachycardia (p <0.001) and hypotension (p= 0.006) in Group 1 was significantly higher than in Group 2. TWL% and EWL% values were similar between the two groups at all-time points. Stapler line leakage was not observed in any patient during the postoperative period. Conclusion: Intraoperative hyoscine-N-butylbromide use is not effective on weight loss postoperatively in patients undergoing LSG. Although hypotension and tachycardia occured in some of patients, none of the patients had complaints in the early or long-term postoperative period. The use of hyoscine-N-butylbromide during LSG is safe but does not have any effect on weight loss.