Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2023; 15(12): 2093-2100
Published online Dec 15, 2023. doi: 10.4251/wjgo.v15.i12.2093
Effect of ultrasound-guided lumbar square muscle block on stress response in patients undergoing radical gastric cancer surgery
Dong-Xiao Zhu, Meng Zhang, Yi-Xin Wang, Meng-Jiao Guo, Dan-Dan Xu, Xin-Ran Wang
Xin-Ran Wang, Dan-Dan Xu, Meng-Jiao Guo, Yi-Xin Wang, Meng Zhang, Dong-Xiao Zhu, Department of Ultrasound, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu Province, China
Co-first authors: Xin-Ran Wang and Dan-Dan Xu.
Author contributions: Wang XR and Xu DD contributed equally to this work; Wang XR, Xu DD, Guo MJ, Wang YX, Zhang M, and Zhu DX designed the research study; Wang XR, Xu DD, Guo MJ, Wang YX, Zhang M, and Zhu DX performed the research; Xu DD and Guo MJ contributed new reagents and analytic tools; Wang XR, and Zhu DX analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript. Wang XR and Xu DD contributed equally to this work as co-first authors. The decision to designate Wang XR and Xu DD as co-first authors is based in three primary reasons. First, the research was performed as a collaborative effort, and the designation of co-first authors accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant manuscript. Designating two first authors will ensure effective communication and management of post-submission matters, which will enhance the paper's quality and reliability. Second, the research team consisted of authors with diverse expertise and skills from various fields, and the designation of two co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, both Wang XR and Xu DD Made substantial and equal contributions throughout the research process. Selecting these researchers as co-first authors acknowledges and respects their equal contribution and exemplifies the collaborative spirit and teamwork within this study. In summary, we believe that designating Wang XR and Xu DD as co-first authors is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Institutional review board statement: This study was reviewed and approved by the Affiliated Hospital of Jiangnan University.
Informed consent statement: Prior to the study, informed consent forms were obtained from all patients.
Conflict-of-interest statement: All authors have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house Author 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: Dong-Xiao Zhu, Doctor, Staff Physician, Department of Ultrasound, Affiliated Hospital of Jiangnan University, No. 1000 Hefeng Road, Wuxi 214122, Jiangsu Province, China. acm18990505@163.com
Received: September 12, 2023
Peer-review started: September 12, 2023
First decision: September 26, 2023
Revised: October 7, 2023
Accepted: November 25, 2023
Article in press: November 25, 2023
Published online: December 15, 2023
Processing time: 92 Days and 19.9 Hours
Abstract
BACKGROUND

Radical surgery is a common treatment for patients with gastric cancer; however, it can lead to postoperative complications and intestinal barrier dysfunction. Ultrasound-guided quadratus lumborum block is often used for postoperative analgesia, but its effects on stress response and intestinal barrier function are not well understood.

AIM

To investigate the effects of an ultrasound-guided quadratus lumborum block on stress response and intestinal barrier function in patients undergoing radical surgery for gastric cancer.

METHODS

A total of 100 patients undergoing radical surgery for gastric cancer were randomly categorized into observation and control groups. Plasma adrenaline and cortisol levels, intestinal mucosal barrier indexes, and complication rates were compared between the two groups before, during, and 1 day after surgery.

RESULTS

The observation group had significantly lower plasma adrenaline and cortisol levels during surgery and at 1 day postoperatively than that of the control group (P < 0.05). Additionally, intestinal barrier indexes (endotoxin and D-dimer) at 1 day postoperatively were significantly lower in the observation group than in the control group (P < 0.05).

CONCLUSION

Ultrasound-guided quadratus lumborum block could reduce stress response, protect intestinal barrier function, and decrease the incidence of complications in patients undergoing radical surgery for gastric cancer. This technique has the potential for clinical applications.

Keywords: Ultrasound-guided quadratus lumborum block; Radical gastric cancer surgery; Stress response; Intestinal barrier function; Postoperative analgesia; Rehabilitation

Core Tip: Ultrasound-guided quadratus lumborum block reduces stress response and preserves intestinal barrier function following radical surgery for gastric cancer, potentially lowering the associated complications. This technique shows promise in providing postoperative analgesia and for improving patient outcomes. It protects the intestinal barrier function and reduces the incidence of complications in patients who undergo radical gastric cancer surgery, highlighting its potential clinical use.