TY  - JOUR
AB  - BACKGROUND: Distal pancreatectomy (DP) can worsen pancreatic endocrine function. Effects on glucose metabolism and underlying mechanisms after DP remains a topic of significant interest and not yet fully understood. This study aimed to examine the impact of DP on blood glucose homeostasis with a particular focus on metabolic outcomes and development of postoperative diabetes. METHODS: Considered were all patients who underwent DP between 01/2010 and 09/2021 and participated simultaneously in extended blood glucose monitoring with a 12 months follow-up. Blood samples were analyzed for markers of pancreatic endocrine function both fasting and after an oral glucose tolerance test preoperatively and 3 and 12 months after DP. RESULTS: Included patients (n = 69) were preoperatively categorized into three groups according to American Diabetes Association (ADA) criteria: 17 patients (24.6%) were normoglycemic (NG), 22 (31.9%) had prediabetes (impaired fasting glucose / impaired glucose tolerance - IFG/IGT) and 30 (43.5%) had diabetes mellitus (DM). In the NG subgroup, beta-cell function (HOMA2%B - updated homeostasis model assessment) significantly decreased from 117.4% (101.1-135%) to 66.9% (49.7-102.1%) at 12 months postoperatively (p < 0.05). Insulin sensitivity (HOMA2%S) significantly increased from 48.2% (33.4-66.9%) to 63.5% (49.8-86%) at 12 months postoperatively (p < 0.05). In the IFG/IGT subgroup, there was a non-significant trend of decreased HOMA2%B and increased HOMA2%S postoperatively. Postoperatively, 11.8% of NG patients and 60% of prediabetic patients developed DM. CONCLUSION: DP already leads to significant changes in glucose metabolism within a 12 month follow-up period. Patients with preoperative prediabetes are particularly at high risk of developing postoperative DM. Therefore, the indication for DP should be critically evaluated, especially in cases with a relative indication for surgery. If possible parenchymal sparing surgical options should be contemplated. TRIAL REGISTRATION: Not applicable.
AU  - Kalandarishvili, M.*
AU  - Oehme, F.*
AU  - Radulova-Mauersberger, O.*
AU  - Kipke, N.
AU  - Solimena, M.
AU  - Teske, C.*
AU  - Mibelli, N.*
AU  - Weitz, J.
AU  - Distler, M.
AU  - Hempel, S.*
C1  - 74040
C2  - 57303
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Glucose metabolism after distal pancreatectomy - deterioration of beta cell function becomes noticeable at an early stage: A retrospective cohort study.
JO  - BMC Surg.
VL  - 25
IS  - 1
PB  - Bmc
PY  - 2025
ER  - 

TY  - JOUR
AB  - BACKGROUND: Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to improve the perioperative management of patients at risk for ABT. METHODS: Patients admitted between 2014 and 2016 in a high-volume thoracic surgery clinic were retrospectively evaluated in a cohort study based on a control group without ABT and the ABT group requiring packed red blood cell units within 15 days postoperatively until discharge. The association of ABT with clinically established parameters (sex, preoperative anemia, liver and coagulation function, blood groups, multilobar resections) was analyzed by contingency tables, receiver operating characteristics (ROC) and logistic regression analysis, taking into account potential covariates. RESULTS: 60 out of 529 patients (11.3%) required ABT. N1 and non-T1 tumors, thoracotomy approach, multilobar resections, thoracic wall resections and Rhesus negativity were more frequent in the ABT group. In multivariable analyses, female sex, preoperative anemia, multilobar resections, as well as serum alanine-aminotransferase levels, thrombocyte counts and Rhesus negativity were identified as independent predictors of ABT, being associated with OR (95% Confidence interval, p-value) of 2.44 (1.23-4.88, p = 0.0112), 18.16 (8.73-37.78, p < 0.0001), 5.79 (2.50-13.38, p < 0.0001), 3.98 (1.73-9.16, p = 0.0012), 2.04 (1.04-4.02, p = 0.0390) and 2.84 (1.23-6.59, p = 0.0150), respectively. CONCLUSIONS: In patients undergoing major lung cancer resections, multiple independent risk factors for perioperative ABT apart from preoperative anemia and multilobar resections were identified. Assessment of these predictors might help to identify high risk patients preoperatively and to improve the strategies that reduce perioperative ABT.
AU  - Stoleriu, M.-G.
AU  - Gerckens, M.
AU  - Zimmermann, J.*
AU  - Schön, J.*
AU  - Damirov, F.*
AU  - Samm, N.*
AU  - Kovács, J.*
AU  - Stacher-Priehse, E.*
AU  - Kellerer, C.*
AU  - Jörres, R.A.*
AU  - Kauke, T.*
AU  - Ketscher, C.*
AU  - Grützner, U.*
AU  - Hatz, R.*
C1  - 67515
C2  - 54080
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Preoperative risk factors predict perioperative allogenic blood transfusion in patients undergoing primary lung cancer resections: a retrospective cohort study from a high-volume thoracic surgery center.
JO  - BMC Surg.
VL  - 23
IS  - 1
PB  - Bmc
PY  - 2023
ER  -