Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
Anticancer Res. 2022 Dec;42(12):5833-5837. doi: 10.21873/anticanres.16091.
BACKGROUND/AIM: Recently, a decrease in serum zinc levels and the need for zinc preparations have been reported in the perioperative period of gastrointestinal surgery. In this study, we examined treatment outcomes among patients supplemented with zinc after pancreaticoduodenectomy (PD) and evaluated the significance of zinc replacement therapy.
From June 2020 to April 2021, 56 patients who received zinc acetate hydrate (50 mg/day) from postoperative day 3 after PD in our department were retrospectively reviewed. Patients' characteristics and preoperative as well as postoperative data, including serum zinc levels and surgical results at 1 month were reviewed.
Preoperative zinc deficiency was present in 86.1% (46/56) of the patients. Moreover, despite zinc supplementation, 17.8% (10/56) of patients had postoperative zinc deficiency. A comparison between the low zinc level group (Zn <80 μg/dl) and the normal zinc level group (Zn ≥80 μg/dl) after surgery showed siginificant differences among patients with malignant diseases (vs. benign diseases, p=0.044), those undergoing open surgery (vs. minimally invasive surgery, p=0.036), and those with intraoperative blood loss ≥346 ml (vs. <346 ml: p=0.041) in the univariate analysis. Multivariate analysis revealed that zinc deficiency was significantly associated with open surgery [odds ratio (OR)=15.885, 95% confidence interval (CI)=1.77-142.01, p=0.013] and intraoperative blood loss (OR=9.329, 95% CI=1.50-57.74, p=0.016).
In patients undergoing open PD for pancreatic cancer, zinc preparations of 50 mg may not be sufficient and further supplementation may be necessary.
背景/目的：最近有报道称，在胃肠外科围手术期，血清锌水平下降，需要补锌。本研究旨在观察胰十二指肠切除术后（PD）补锌患者的治疗效果，并评估补锌替代疗法的意义。
回顾性分析 2020 年 6 月至 2021 年 4 月我院行 PD 术后第 3 天开始口服醋酸锌（50mg/天）的 56 例患者的临床资料。分析患者的一般资料、术前及术后（1 个月）的相关数据，包括血清锌水平及手术结果。
术前锌缺乏的患者占 86.1%（46/56）。尽管进行了补锌治疗，但仍有 17.8%（10/56）的患者术后仍存在锌缺乏。术后低锌水平组（Zn<80μg/dl）与正常锌水平组（Zn≥80μg/dl）比较，发现恶性肿瘤患者（vs.良性疾病患者，p=0.044）、行开腹手术患者（vs.微创患者，p=0.036）、术中出血量≥346ml 患者（vs. <346ml：p=0.041）间存在显著差异。多因素分析显示，开腹手术（OR=15.885，95%CI=1.77-142.01，p=0.013）和术中出血量（OR=9.329，95%CI=1.50-57.74，p=0.016）与锌缺乏显著相关。
对于行开腹 PD 的胰腺癌患者，50mg 锌制剂可能不足，需要进一步补充。
