Department for Abdominal and General Surgery, University Clinical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
Biomolecules. 2021 Oct 29;11(11):1601. doi: 10.3390/biom11111601.
Laparoscopic surgery produces lesser postoperative inflammation with a smaller cytokine and leptin response, and might thus reduce postoperative anorexia compared with open surgery. The aim of the present study was to determine the role of serum leptin in postoperative anorexia after laparoscopic gastric cancer surgery.
Fifty-four consecutive patients with adenocarcinoma of the stomach were operated on either with open or laparoscopic surgery. Correlations were determined between the serum levels of leptin, clinico-pathological characteristics, serum haemoglobin, and albumin.
Serum leptin levels on day seven were correlated significantly to gender ( = 0.004), body mass index (BMI) ( = 0.002), and tumour grade ( = 0.033). In the patients with C-reactive protein (CRP) < 100 mg/L ( = 46) the leptin levels on day seven were significantly lower after the laparoscopic operation ( = 0.042) and in patients with lower BMI ( = 0.001). The linear regression model determined a significant correlation between the relative concentration of leptin on day seven and laparoscopic surgery (Beta-0.688; < 0.0001), gender, BMI, location of the tumour, T stage, N stage, perioperative therapy, tumour grade, perineural invasion, Lauren histological type, and ulceration. In patients with CRP levels below 100 mg/mL, the serum level of albumin on day seven after surgery was significantly higher in patients after laparoscopic surgery.
Laparoscopic surgery produced significantly lower relative leptin concentrations on day seven, and higher serum albumin levels in the subgroup with CRP levels below 100 mg/L at discharge. These results suggested that laparoscopic gastric cancer surgery might reduce postoperative leptin response, leading to a better nutritional status at discharge compared with open surgery.
腹腔镜手术产生的术后炎症较少，细胞因子和瘦素反应较小，因此与开放手术相比，可能会减少术后厌食症。本研究的目的是确定血清瘦素在腹腔镜胃癌手术后术后厌食症中的作用。
54 例腺癌患者行开放或腹腔镜手术。确定血清瘦素水平与临床病理特征、血清血红蛋白和白蛋白之间的相关性。
术后第 7 天血清瘦素水平与性别（ = 0.004）、体重指数（BMI）（ = 0.002）和肿瘤分级（ = 0.033）显著相关。在 C-反应蛋白（CRP）<100mg/L 的患者（ = 46）中，腹腔镜手术后第 7 天的瘦素水平显著降低（ = 0.042），BMI 较低的患者（ = 0.001）。线性回归模型确定了第 7 天瘦素相对浓度与腹腔镜手术（Beta-0.688；<0.0001）、性别、BMI、肿瘤位置、T 分期、N 分期、围手术期治疗、肿瘤分级、神经周围侵犯、Lauren 组织学类型和溃疡之间的显著相关性。在 CRP 水平低于 100mg/mL 的患者中，腹腔镜手术后第 7 天血清白蛋白水平在 CRP 水平低于 100mg/mL 的患者中显著升高。
腹腔镜手术在术后第 7 天产生的相对瘦素浓度显著降低，并且在 CRP 水平低于 100mg/L 的亚组中，术后第 7 天血清白蛋白水平升高。这些结果表明，与开放手术相比，腹腔镜胃癌手术可能会减少术后瘦素反应，从而在出院时改善营养状况。
