| Objective To evaluate the the degree of trauma from minimally invasive surgery and open surgery of Siewert type II esophageal gastric junction adenocarcinoma by investigating the variation of IL-6 and CRP concentration.Methods 99 patients with Siewert type II esophageal gastric junction adenocarcinoma Were selected and received minimally invasive surgery and open surgery in our center,Anhui Provincial Hospital Affiliated with Anhui Medical University.The concentration of IL-6 were detected;Of those 60 patients,30 underwent minimally invasive surgery and 30 recieved open surgery.Male 46 cases,Female 14 cases?The concentration of CRP were detected;Of those 90 patients,39 underwent minimally invasive surgery and 60 recieved open surgery.Male 81 cases,Female 18 cases?Age 46-80 years,Preoperative examinations include:Routine preoperative blood tests include(Blood routine,urine routine,biochemical,blood coagulation and immune combination)? Other tests include(Lung function,electronic gastroscope,electrocardiogram,cardiac ultrasound,upper gastrointestinal contrast,chest and abdomen CT scan plus enhancement)?Tumor staging using AJCC Seventh Edition TNM staging.Preoperative anesthesia doctors according to the American Society of anesthesiologists standard preoperative assessment,The resected lymph nodes were grouped by surgeons,Count is counted by pathologist.The concentration of IL-6 were detected by ELISA and CRP were detected by CRP immunofluorescence dry quantitative method,Venous blood samples were collected 3ml,3600 rpm /min centrifugation to extract plasma,Refrigerator preservation and testing at-20 DEG c,Blood sampling time is set at 6 a.m.to 10 a.m.T test and ?2 test were used to compare the changes(1)Comprehensive analysis of gender,age,preoperative complications,postoperative drainage time,Postoperative hospitalization time,intraoperative blood loss,postoperative clinical pathological features and operation time.(2)serum IL-6 and CRP concentration between the two groups before operation and on the 1st,the third day and the seventh day after surgery.Results The two groups were similar in terms of age,sex and preoperative complications.The minimally invasive surgery approach was associated with no significant decrease in postoperative pathological stage,surgical blood loss,duration of operation,perioperative mortality and the overall incidence of complications relative to the open surgery approach.Compared with the traditional open,Minimally invasive thoracic drainage time and hospitalization time were short,There was statistical significance.(IL-6;8.867±2.063 d VS 11.466±3.848 d,t = 4.950,p = 0.002)(CRP;7.33±2.22 d VS 8.62±3.47 d,t = 0.749,p = 0.043)(IL-6;12.066±1.660 d VS 15.033±4.287 d,t =10.495,p = 0.001)(CRP;11.87±1.88 d VS 13.47±4.18 d,t = 5.051,p = 0.027)?There was no significant difference between two groups in the day before surgery,the 7th day afer surgery of the concentration of CRP and IL-6 of two groups(P?0.05).The minimally surgery approach was associated with significantly lower concentration of IL-6 and CRP of the first day and the 3th day after surgery than the open surgery approach(P?0.05).(First days after operation IL-6;17.197±13.708(pg/ml)VS 63.576±42.957(pg/ml),t = 17.010,p = 0.000?Third days after operation IL-6;9.005±6.458(pg/ml)VS 32.357±31.579(pg/ml),t = 19.016,p = 0.000),(First days after operation CRP;81.210±29.450(ml/L)VS 136.200±36.530(ml/L),t = 6.701,p = 0.000?Third days after operation CRP;36.370±18.380(ml/L)VS 58.440±26.350(ml/L),t = 2.108,p = 0.000).There were statistically significant difference in the concentration of IL-6 of different time points of two groups according to bivariate repeated measurement data(P< 0.05).Conclusion The patients with Siewert type II esophageal gastric junction adenocarcinoma have lower operative wound than open surgery. |
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