Effects of thoracoscopic radical resection of esophageal cancer on postoperative traumatic stress, immune function and micrometastasis

Abstract

Objective To observe the effects of thoracoscopic radical resection of esophageal cancer on postoperative traumatic stress, immune function and micrometastasis. Methods A total of 98 patients with esophageal cancer admitted to Changzhi Medical College Affiliated Peace Hospital from October 2016 to October 2018 were selected for the study. According to the surgical methods, they were divided into thoracoscopic group (n=49, given thoracoscopic radical resection of esophageal cancer) and open group (n=49, given open radical resection of esophageal cancer). The perioperative indexes such as operative time, traumatic stress-related indicators, including C-reactive protein (CRP), free-triiodothyronine (FT3) and free thyroxine (FT4), immune function (CD3+ , CD4+ , CD8+ ) and micrometastasis-associated cytokines including interleukin-1β (IL-1β) and high mobility group protein B1 (HMGB1), were compared between the two groups. Results The intraoperative blood loss and postoperative observation indexes (extraction time, hospital stay) in thoracoscopic group were significantly lower than those in open group (P 0.05). CRP was significantly increased in the two groups 1 d after operation (P 0.05). On 1 d after operation, the levels of serum T cell subsets (CD3+ , CD4+ , CD8+ ) were significantly decreased in the two groups (P<0.05), but the above-mentioned serum T cell subsets in thoracoscopic group were higher than those in open group 1 d after operation (P<0.05). On 7 d after operation, the levels of serum micrometastasis-associated cytokines (IL-1β, HMGB1) were significantly increased in the two groups (P<0.05), and the levels of IL-1β and HMGB1 in thoracoscopic group 7 d after operation were lower than those in open group (P<0.05). Conclusions There is no significant difference in the stress level between patients undergoing thoracoscopic radical resection of esophageal cancer and open radical resection of esophageal cancer. However, the former one has smaller effects on immune function and micrometastasis, and it is more conducive to postoperative recovery. Key words: Esophageal cancer; Thoracoscopic radical resection of esophageal cancer; Open radical resection of esophageal cancer; Stress