Yao S, Yuan Y, Zhang J, Yu Y, Luo GH. Gene polymorphisms associated with sudden decreases in heart rate during extensive peritoneal lavage with distilled water after gastrectomy. World J Gastrointest Surg 2023; 15(10): 2154-2170 [PMID: 37969699 DOI: 10.4240/wjgs.v15.i10.2154]
Corresponding Author of This Article
Guang-Hua Luo, PhD, Chief Technician, Clinical Medical Research Center, the Third Affiliated Hospital of Soochow University, No. 185 Juqian Street, Changzhou 213000, Jiangsu Province, China. shineroar@163.com
Research Domain of This Article
Geriatrics & Gerontology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2154-2170 Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2154
Gene polymorphisms associated with sudden decreases in heart rate during extensive peritoneal lavage with distilled water after gastrectomy
Shuang Yao, Yan Yuan, Jun Zhang, Yang Yu, Guang-Hua Luo
Shuang Yao, Jun Zhang, Yang Yu, Guang-Hua Luo, Clinical Medical Research Center, The Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu Province, China
Yan Yuan, Department of Anesthesiology, The Third Affiliated Hospital of Soochow University, Changzhou 213000, Jiangsu Province, China
Author contributions: Luo GH designed the research study; Yao S and Yuan Y wrote the manuscript; Yao S, Zhang J and Yu Y performed the experiments and analyzed the data; All authors have read and approved the final manuscript.
Supported byChangzhou Sci and Tech Program, No. CJ20210113; Changzhou Health Young Talents Plan, No. CZQM2021006.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Third Affiliated Hospital of Soochow University.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guang-Hua Luo, PhD, Chief Technician, Clinical Medical Research Center, the Third Affiliated Hospital of Soochow University, No. 185 Juqian Street, Changzhou 213000, Jiangsu Province, China. shineroar@163.com
Received: April 28, 2023 Peer-review started: April 28, 2023 First decision: July 23, 2023 Revised: August 4, 2023 Accepted: August 17, 2023 Article in press: August 17, 2023 Published online: October 27, 2023 Processing time: 182 Days and 1.1 Hours
ARTICLE HIGHLIGHTS
Research background
Peritoneal lavage with distilled water to kill residual tumor cells is a routine procedure in gastrectomy, but this procedure often causes a sudden decrease in heart rate (HR) in some patients.
Research motivation
To investigate whether there are differences in genetic background between patients with discordant HR changes and help clinicians to better assess the perioperative risk of patients undergoing gastrectomy.
Research objectives
To investigate whether genotypes, genetic patterns, single nucleotide polymorphism (SNP)-SNP and SNP-environment interactions were associated with high heart rate variability (HRV).
Research methods
A total of 192 patients who underwent distal gastrectomy were divided into two groups according to changes in HR (using 30% and 15% as cutoffs). Two-dimensional polymerase chain reaction was used to establish a single-tube method to detect telomerase-associated protein 1 (TEP1) rs938886 and rs1713449 and RecQ like helicase 5 (RECQL5) rs820196. Genotypes, genetic patterns and the interaction of SNP-SNP and SNP-environment were analyzed by non-conditional logistic regression model and generalized multifactor dimensionality reduction.
Research results
The polymorphism of the RECQL5 gene (rs820196) was associated with a sudden decrease in HR during abdominal lavage in patients with gastric cancer. Rs820196-smoking and rs820196-hypertension were associated with HRV ≥ 15%. Nonsmokers carrying the TC genotype of rs820196 and patients carrying the GC-CT-TC genotype of rs938886, rs1713449 and rs820196 had higher HRV risk.
Research conclusions
The polymorphisms of RECQL5 (TC genotype of rs820196) and TEP1 (GC-CT genotype of rs938886 and rs1713449) genes were associated with HRV.
Research perspectives
HRV risk assessment in patients who are about to undergo peritoneal lavage is helpful for perioperative safety. This cost-effective SNP screening method can be extended to other patients undergoing tumor resection (such as breast cancer, lung cancer and other gastrointestinal cancer) and multicenter studies.
