Effect Of Retroperitoneal Laparoscopic Nephrectomy On Erythrocyte CR1 Activity

Objective This experiment was settedde up two control groups ofRetroperitoneal laparoscopic nephrectomy and Extraperitoneal nephrectomyunder the12th rib to measure preoperative,intraoperative andpostoperative1d,4d’ RBC-C3bRR and RBC—ICR of patients. To observe thechange of erythrocytic immune function， To discusse the superiority ofRetroperitoneal laparoscopic nephrectomy and the erythrocyte CR1immunemechanism after Retroperitoneal laparoscopic nephrectomyMethods Data of thirty patients with benign diseases who performedselective unilateral nephrectomy were underwent linking patient’s preferenceand doctor’s advice in our hospital. they would be divided into control group ofRetroperitoneal laparoscopic nephrectomy and reference group ofextraperitoneal nephrectomy under the12th rib on average.the group(LK6andRK9,male8and female7) included10cases urinary calculi,2cases renal cyst,2casas polycystic kidney,1casa stenosis of ministry of join of congenitalureteropathy pelvi.the control group(LK7and RK8,male5and female5)included12cases urinary calculi,1cases renal cyst,2casas polycystic kidney.The patients at the age of40to60without other system diseases previoususe of glucocorticoids and immune inhibitor nesrly three months. the generalconditions of patients were recorded routinely, referring to body temperature,volume of blood loss, Intraoperative anesthetic time, rete of postoperativecomplications, and recovered time of gastroenteric function, Postoperativedrainage tube time, as well as days of hospital stay.Blood samples were taken at pre-operation,intranperative period andpostoperative1d and4d in two groups patients’RBC-C3bRR and RBC-ICR were detected by the Garland test．Eventually Datas were dealed with SPSSl8.0．Results1.The general conditions of two groups’body temperature,pulseand blood pressure:For observation group(LS):preoperative:36.52±0.32℃、73±8once/min、122±15/80±6mmHg，intraoperative:36.42±0.41℃、85±21once/min、125±21/83±7mmHg，poseoperative1d:37.12±0.53℃、89±18once/min、127±19/82±5mmHg，poseoperative4d:36.42±0.41℃、75±9once/min、123±18/81±8mmHg，for control group(open surgery):preoperative:36.42±0.21℃、74±7once/min、123±13/81±5mmHg，intraoperative:36.34±0.52℃、84±22once/min、125±21/83±7mmHg，poseoperative1d:37.77±0.52℃、89±19once/min、127±19/82±5mmHg，poseoperative4d:36.42±0.22℃、76±7once/min、123±18/81±8mmHg，P=0.71,it was no significant difference between the two groups.there weren’tany complication occurred during surgery and after procedures in both groups,the all of laparoscopic surgerys were finished successfully, no case failed. therewas less blood loss during the surgerys,the average blood loss was50.30±20.33ml,which was less than100.74±30.72ml in control group，it isstatistical significant,p=0.032.the number of Intraoperative Anesthesia time forobservation group(LS)(108.31±42.46min)is lower than the control group(opensurgery)(125.41±40.34min). it is statistical significant,p=0.023.GI function recovered more slowly in the control group(open surgery)(42.21±14.71h) than that in the observation group(LS)(26.21±11.74h),p=0.018.(4) the Postoperative drainage tube time for observation group(LS)(54.21±10.74h)was less than the control group(opensurgery)(72.21±11.72h),p=0.021.T he days of hospital stay for observationgroup(LS) what is6days on average that is shorter than the controlgroup(open surgery) what is10days.2. The CR1Biological activity measurement:the RBC-C3bRR:For observation group(LS),preoperative:23.41±5.11、intraoperative:5.35±1.01、postoperative1d:6.74±2.08、postoperative4d:14.55±4.51.for control group(open surgery):preoperative:23.42±4.41、intraoperative:10.25±2.66、postoperative1d:12.58±3.15、postoperative4d:19.38±5.51The RBC-ICR:For observation group(LS):preoperative:11.56±3.01、intraoperative:26.77±6.25、postoperative1d:29.78±9.18、postoperative4d:27.44±5.84、for control group(open surgery):preoperative:11.26±2.31、intraoperative:17.77±5.75、postoperative1d:19.48±5.88、postoperative4d:16.25±6.55it is statistical significant,p<0.05.Conclusion Retroperitoneal laparoscopic nephrectomy has a morefavorable clinical outcome because of quicker recovery of gastrointestinal andless tissue trauma,it obviously improves the quality of medical treatment andreduces the patients pain. The two groups all cause the loss of activity oferythrocyte CR1.the erythrocyte CR1immune adhesion activity decreased invivo of Retroperitoneal laparoscopic nephrectomy is significantly lower in theopen extraperitoneal nephrectomy.