Influence of laparoscopic radical gastrectomy on immune function and coagulation function and prognosis
10.3760/cma.j.cn112152-20190731-00482
- VernacularTitle:腹腔镜胃癌根治术对患者免疫功能凝血功能及预后的影响
- Author:
Junbao GU
1
;
Xuebin BAO
;
Zhao MA
Author Information
1. 河南省人民医院 郑州大学人民医院胃肠外科 450000
- Keywords:
Gastric neoplasms;
Laparoscopic radical gastrectomy;
Immune function;
Coagulation function;
Prognosis
- From:
Chinese Journal of Oncology
2020;42(7):598-602
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influence of laparoscopic radical gastrectomy on patients′immune functions, coagulation functions and prognoses.Methods:Fifty-eight patients with gastric cancer who underwent laparoscopic radical gastrectomy (laparoscopic group) and 40 patients with gastric cancer who underwent traditional open surgery (traditional group) in Henan People′s Hospital from May 2016 to May 2018 were selected as the subjects. The immune function and coagulation function were compared between the two groups before and after operation. The prognoses of patients underwent laparoscopic radical gastrectomy and the influencing factors were analyzed.Results:Three days after operation, the CD4 + level and CD4 + /CD8 + ratio in laparoscopic group were (29.78±3.58)% and (1.01±0.18), higher than (27.23±3.47)% and (0.93±0.14) in control group ( P<0.05). Three days after operation, the activated partial thromboplastin time (APTT) in laparoscopic group was (26.55±2.56) seconds, shorter than (27.86±2.73) seconds in traditional group, while the levels of fibrinogen (FIB) and D-dimer were (4.24±0.84) g/L and (377.91±47.19) μg/L, higher than (3.88±0.75) g/L and (330.28±45.11) μg/L in traditional group ( P<0.05). The 5-year survival rate was 77.5% in traditional group and 72.4% in laparoscopic group, without significant difference ( P>0.05). Multivariate analysis showed that lymph node metastasis was the independent risk factor for prognosis of laparoscopic radical gastrectomy ( P<0.05). Conclusions:Laparoscopic radical gastrectomy can effectively reduce postoperative immunosuppression, but affect postoperative coagulation function. Lymph node metastasis is closely related to the prognosis of patient with gastric cancer. The patient′s condition should be comprehensively evaluated before and after operation to determine whether the laparoscopic operation is suitable, for reducing postoperative complications and improving the prognosis.
