| Objective:Through the comparative study of radical clinical observation data and laboratory test data of the recent operation of laparoscopic and open gastrectomy to investigate the safety, feasibility and advantages of laparoscopic radical resection of gastric cancer.Methods:A total of 78 cases in Lu’an Affiliated Hospital of Anhui Medical University hospital department of general surgery in 2014.5-2015.12 were diagnosed by gastroscopy for patients with gastric cancer. According to the random number table, divided into experimental group (38 cases), for laparoscopic radical gastrectomy, control group (40 cases) treated by open radical gastrectomy, According to the inclusion and exclusion criteria, in the end, we selected experimental group 32 cases and control group 35 cases. After operation compared between the two groups with clinical observation indexes include:operative time, bleeding volume, operation incision length, lymph node dissection number, tumor resection margin length, postoperative anal exhaust time, patients began to eat liquid food time, hospitalization time, postoperative complications; laboratory indexes:collected the patients elbow venous blood in preoperative 24h, postoperative 24h,72h,120h, test the AST, ALT,Cr,WBC, NE(%), hs-CRP, IL-6, TNF-a et al. Through the statistical analysis of the indicators of clinical observation and laboratory indexes.Results:Laparoscopic surgery group 4 cases for intraoperative exploration of late stage cancer,2 cases were converted to open surgery were excluded, Finally,32 cases into experimental group,the open gastrectomy group of 5 cases intraoperative exploration of late stage cancer were excluded, final 35 cases in control group. Two groups of patients with general information (gender, age, BMI, whether preoperative complications, tumor location, surgical resection, combined organ resection rate,postoperative UICC stage), P>0.05, no significant difference between the two groups illustrate that the data of two groups were comparable. Compared of cutting edge distance, the number of lymph node and the proximal and distal tumor were P>0.05, there was no significant difference; In the incision length, bleeding volume, postoperative ventilation time, patients with began eat liquid time and postoperative hospitalization time, the laparoscopic group less than open group,compared to P<0.05, the difference was statistically significant; Compared two groups of operation time, laparoscopic group longer than open group (P<0.05, the difference was statistically significant); liver and kidney function:two groups of patients preoperative 24h AST, ALT, Cr were no statistically significant difference (P>0.05), the level of Cr in laparoscopic group was higher than the open group at postoperative 24h (P<0.05), the difference in the two groups were statistically significant, compared with the level of AST and ALT at postoperative 24h,72h,120h, P>0.05, there was no significant difference,the level of Cr in two groups at postoperative 72h,120h, compared to P>0.05, there was no significant difference; comparison of inflammatory reaction:two groups patients preoperative 24h,the level of WBC, NE(%), hs-CRP, IL-6, TNF-alpha test index comparison, P>0.05, no significant difference, after the operation of the relevant indicators of inflammation compared with preoperative had increased, reached the peak at postoperative 24h, and the open group were higher than the laparoscopic group, P<0.05, the difference was statistically significant, postoperative 72h the indexes had decreased, two groups of WBC and NE (%) compared to P>0.05, the difference was no statistically significant, but hs-CRP, IL-6, TNF-alpha in the open group were still higher than the laparoscopic group, P<0.05, the difference was statistically significant, and postoperative 120h the level of IL-6, hs-CRP in the open group was still higher than the laparoscopic group, P<0.05, the difference was statistically significant, theother index contrast showed no significant difference,P< 0.05. Postoperative complications: the laparoscopic group there were 5 cases with complications, open group there were 6 cases of complications,compared to P> 0.05, there was no statistical difference in two groups.Conclusion:Compared with traditional open radical surgery, laparoscopic radical gastrectomy for gastric cancer can achieve the same tumor curative effect, with the advantage of less intraoperative hemorrhage quantity and postoperative recovery fast, but the operation time is longer than open group, the effect of early renal function was significantly larger than the open group, laparoscopic radical gastrectomy and open radical gastrectomy can cause the body’s inflammatory response, the postoperative inflammatory markers were significantly increased than the preoperative, but the laparoscopic group increased amplitude less than the open group,show that laparoscopic radical gastrectomy can reduce the body’s inflammatory stress response. At the same time, the laparoscopic radical gastrectomy will not increase the postoperative complications incidence, prove it is safe. |
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