Abstract
BackgroundTo evaluate the immune function of gastric cancer patients after single-incision laparoscopic distal gastrectomy (SIDG) or multiport laparoscopic distal gastrectomy (MLDG) guided by enhanced recovery after surgery (ERAS).MethodsA retrospective cohort study was performed on 120 patients who underwent laparoscopic distal gastrectomy for gastric cancer. The patients were divided into two groups according to operation method: group A (MLDG) and group B (SIDG), both guided by ERAS concept. The indicators reflecting immune function and inflammation, such as CD3+, CD4+, CD8+ and NK cell count, CD4+/CD8+ cell ratios, IgA, IgM and IgG levels, C-reactive protein (CRP), total lymphocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) were tested 3 days and 7 days after surgery.ResultsThe skin incision length of patients in group B was significantly shorter than that in group A, but the operation time was significantly longer in group B than that in group A (P < 0.05). There were no significant differences in preoperative CD3+, CD4+, CD8+, natural killer (NK) cells, CD4+/CD8+, IgA, IgM and IgG levels between two groups (P < 0.05). Three days after surgery, the immune function indices were decreased in both groups, but with no significant difference between two groups (P > 0.05). On the 7th day after surgery, the immune indexes of both groups recovered somewhat, approaching the preoperative level (P > 0.05). Inflammation indexes increased 3 days after surgery and decreased 7 days after surgery in both groups, among them the CRP level in group A was higher than that in group B (P < 0.05). The 3-year survival rate were 96.7% in group A and 91.7% in group B, respectively, with no statistically significant difference.ConclusionCompared with MLDG guided by ERAS, SIDG under the guidance of the ERAS concept has better cosmetic effect and similar effect on immune function of gastric cancer patients.
Highlights
Gastric cancer is still a high incidence tumor and a major cause of cancer death globally [1]
The patients were divided into two groups according to operation method: group A was performed traditional multiport laparoscopic distal gastrectomy (MLDG) guided by enhanced recovery after surgery (ERAS) concept; group B was performed single-incision laparoscopic distal gastrectomy (SIDG) guided by ERAS concept
Inclusion criteria were: (1) Tumor clinical stage was I A or I B according to the seventh edition of American Joint Committee on Cancer (AJCC) [17]; (2) Conventional Laparoscopic distal gastrectomy (LDG) and SIDG were performed along with D1 or D1+ lymph node dissection; (3) All the operations were performed by the same surgeon
Summary
Gastric cancer is still a high incidence tumor and a major cause of cancer death globally [1]. Laparoscopic distal gastrectomy (LDG) has become one of the standard surgical procedures for treatment of early distal gastric cancer [3]. The single-incision laparoscopic surgery (SILS) has certain advantages in reducing trauma and shortening postoperative recovery time, which well fits the concept of ERAS [6, 7]. With the rise of SILS and the application of the concept of ERAS, a new door has been opened for minimally invasive treatment of gastric cancer patients [8, 9]. To evaluate the immune function of gastric cancer patients after single-incision laparoscopic distal gastrectomy (SIDG) or multiport laparoscopic distal gastrectomy (MLDG) guided by enhanced recovery after surgery (ERAS)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
