Effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress, immune responses and intestinal barrier function in elderly patients with esophageal cancer

Abstract

Objective To analyze the effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress, immune responses and intestinal barrier function in elderly patients with esophageal cancer. Methods A prospective study including 55 elderly esophageal cancer patients undergoing laparoscope-assisted Ivor-Lewis surgery(the treatment group, n=25)and Ivor-Lewis surgery(the control group, n=25)was conducted.The white blood cell count, neutrophil-to-lymphocyte ratio, percentages of CD4 and CD8 cells, CD4/CD8 ratio, C reactive protein(CRP)and D-lactic acid levels were compared between the two groups before and at 1, 4 and 7 d after operation. Results The white blood cell count(t=2.689, P=0.010)and neutrophil-to-lymphocyte ratio(t=3.300, P=0.002)were lower in the treatment group than in the control group at 1 d after operation.The percentage of CD4 cells was higher in the treatment group than in the control group at 1 d(t=2.242, P=0.029)and 4 d(t=2.031, P=0.047)after operation.The percentage of CD8 cells was higher in the treatment group than in the control group at 1 d after operation(t=2.041, P=0.046). The CD4/CD8 ratio was higher in the treatment group than in the control group at 1 d(t=2.833, P=0.007)and 4 d(t=2.111, P=0.036)after operation.The CRP level was lower in the treatment group than in the control group at 1 d(t=2.267, P=0.028)and 4 d(t=2.111, P=0.036)after operation.The D-lactic acid level was lower in the treatment group than in the control group at 1 d(t=2.267, P=0.028), 4 d(t=7.967, P<0.01)and 7 d(t=2.541, P=0.014)after operation. Conclusions Laparoscope-assisted Ivor-Lewis surgery has good protective effects on perioperative stress, immune responses and intestinal barrier function in elderly patients with esophageal cancer. Key words: Esophageal neoplasms; Laparoscopic; Immunity