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Clinical significance of lipid droplets formed in the peritoneal fluid after laparoscopic surgery for gastric cancer

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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.

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Acknowledgements

The authors thank Dr. Jayoun Kim at the Medical Research Collaborating Center of Seoul National University Hospital for statistical analysis and consultation.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, Seoul, Korea

    Shin-Hoo Park, Seong-Woo Bae, Kyoung-Yun Jeong, Eun-Hee Koo, Seong-Ho Kong, Do Joong Park, Hyuk-Joon Lee & Han-Kwang Yang

  2. Department of Surgery, Seoul National University Hospital, 101 Daehark-ro, Jongno-gu, Seoul, 03080, Korea

    Shin-Hoo Park, Jong-Ho Choi, Ji-Hyeon Park, Seong-Ho Kong, Do Joong Park, Hyuk-Joon Lee & Han-Kwang Yang

  3. Division of Foregut Surgery, Korea University College of Medicine, Seoul, Republic of Korea

    Shin-Hoo Park

  4. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Seong-Woo Bae, Kyoung-Yun Jeong, Eun-Hee Koo, Do Joong Park, Hyuk-Joon Lee & Han-Kwang Yang

  5. National Instrumentation Center for Environmental Management, Seoul National University, Seoul, Korea

    Won-Sil Choi

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Contributions

SHP, and HKY designed the study. SHP, SWB, KYJ, EHK, JHC, JHP, and WSC analyzed and interpreted data. SHP drafted the article. SHP, SHK, DJP, HJL and HKY critically revised the article for important intellectual content. All authors confirmed that the content has not been published elsewhere and does not overlap with or duplicate their published work.

Corresponding author

Correspondence to Han-Kwang Yang.

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Disclosures

Shin-Hoo Park, Seong-Woo Bae, Kyoung-Yun Jeong, Eun-Hee Koo, Jong-Ho Choi, Ji-Hyeon Park, Seong-Ho Kong, Won-Sil Choi, Do Joong Park, Hyuk-Joon Lee, and Han-Kwang Yang have no conflicts of interest or financial ties to disclose.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent to be included in the study or equivalent was obtained from all patients.

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Park, SH., Bae, SW., Jeong, KY. et al. Clinical significance of lipid droplets formed in the peritoneal fluid after laparoscopic surgery for gastric cancer. Surg Endosc 36, 6095–6104 (2022). https://doi.org/10.1007/s00464-022-09173-2

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