Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2154
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
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.
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.
To investigate whether genotypes, genetic patterns, single nucleotide polymorphism (SNP)-SNP and SNP-environment interactions were associated with high heart rate variability (HRV).
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.
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.
The polymorphisms of RECQL5 (TC genotype of rs820196) and TEP1 (GC-CT genotype of rs938886 and rs1713449) genes were associated with HRV.
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.