[Effect of extended paraaortic lymph node dissection on postoperative pancreatic function in gynecologic procedures].
BACKGROUND
We tested a hypothesis that extended gynecological paraaortic lymph node dissection seriously impairs postoperative pancreatic function.


METHODS
We studied 82 patients who underwent gynecologic surgery for malignancy from January, 2002 to October, 2003. After scheduled operation, we assigned them to one of two groups; patients who underwent extended gynecological paraaortic lymph node dissection (n=34) or those who did not (n=48). We measured plasma amylase levels in all patients before operation and 1, 3, 7 days after operation.


RESULTS
Preoperative amylase levels were the same in the two groups. Time-dependent increases in plasma amylase level were noted in both groups. From 1 to 3 days after operation, however, plasma amylase levels were significantly higher in patients who had undergone paraaortic lymph node dissection than in those who had not. Furthermore, lethal postoperative pancreatitis developed in one patient who showed marked high levels in plasma amylase level after paraaortic lymph node dissection.


CONCLUSIONS
Our results suggest that paraaortic lymph node dissection in gynecologic operations seriously impairs pancreatic function and that one should maintain a high suspicion of postoperative pancreatitis.
Izutsu
Miwa
M
Department of Anesthesiology, Yamagata University School of Medicine, Yamagata.
Kamiya
Kouhei
K
Yamakawa
Mayumi
M
Takaoka
Seiji
S
Kudo
Masaya
M
Kotani
Naoki
N
D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood*; D001011:Aorta; D005260:Female; D005833:Genital Neoplasms, Female / Q000503:physiopathology* / Q000601:surgery; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008875:Middle Aged; D010179:Pancreas / Q000503:physiopathology*; D011184:Postoperative Period
D000681:Amylases