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Objective@#To analyze the application of accelerated rehabilitation surgery in elderly patients with gastric cancer surgery and its influence on inflammation and nutritional indicators.@*Methods@#From October 2017 to October 2018, 80 elderly patients with gastric cancer who underwent gastrectomy in Shaoxing People's Hospital were selected.According to random number table method, they were randomly divided into traditional control group and ERAS group, with 40 cases in each group.The traditional control group was treated by traditional perioperative treatment + operation, while ERAS group was treated with ERAS perioperative treatment + operation.The recovery and complications, inflammation and nutritional changes before operation, 1 day after operation and 3 days after operation, and the improvement of quality of life after operation were compared and analyzed between the two groups.@*Results@#In the ERAS group, the first exhaust time[(2.3±0.8)d] and defecation time[(2.5±0.4)d]were shorter than those in the traditional control group[(3.5±0.5)d and (3.7±0.6)d], and the incidence rate of complications (7.5%) was lower than that in the traditional control group (35.0%), the differences were statistically significant (t=8.72, 10.52, χ2=9.04, all P<0.05). On the first day after operation, the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6(IL-6) in the ERAS group were (28.3±4.9)μg/L and (23.1±5.8)μg/L, respectively, which were lower than those in the traditional control group[(39.8±6.7)μg/L and (34.5±8.1)μg/L](t=8.76, 7.24, all P<0.05). The serum TNF-α and IL-6 levels in the ERAS group on the 3rd day after operation were (18.4±6.2)μg/L and (18.3±3.2)μg/L, respectively, which were lower than those in the traditional control group[(26.2±5.1)μg/L and (26.5±4.8)μg/L](t=6.14, 8.99, all P<0.05). The serum levels of albumin (Alb) and prealbumin (PRE) in the ERAS group on the first day after operation were (31.1±0.7)g/L and (161.3±7.2) mg/L, respectively, which were lower than those in the traditional control group[(30.2±0.9)g/L and (154.3±4.8)mg/L](t=4.99, 5.12, all P<0.05). The serum levels of Alb and PRE in the ERAS group on the 3rd day after operation were (33.4±0.5)g/L and (172.1±5.0)mg/L, respectively, which were lower than those in the traditional control group[(31.9±0.8)g/L and (165.3±3.2)mg/L](t=10.06, 7.24, all P<0.05). The WHOQOL-BREF score of the ERAS group[(91.4±6.5)points]was higher than that of the traditional control group[(80.3±7.8)points](P<0.05).@*Conclusion@#Accelerated rehabilitation surgery has good effect for elderly gastric cancer surgery.It can maintain the inflammation and nutritional status of patients after operation.It is worthy of clinical reference.
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Objective To analyze the application of accelerated rehabilitation surgery in elderly patients with gastric cancer surgery and its influence on inflammation and nutritional indicators .Methods From October 2017 to October 2018,80 elderly patients with gastric cancer who underwent gastrectomy in Shaoxing People ＇s Hospital were selected.According to random number table method ,they were randomly divided into traditional control group and ERAS group, with 40 cases in each group.The traditional control group was treated by traditional perioperative treatment +operation,while ERAS group was treated with ERAS perioperative treatment +operation.The recovery and complications, inflammation and nutritional changes before operation , 1 day after operation and 3 days after operation,and the improvement of quality of life after operation were compared and analyzed between the two groups . Results In the ERAS group,the first exhaust time[(2.3 ±0.8)d] and defecation time[(2.5 ±0.4)d]were shorter than those in the traditional control group [(3.5 ±0.5)d and (3.7 ±0.6)d],and the incidence rate of complications (7.5%) was lower than that in the traditional control group (35.0%),the differences were statistically significant (t＝8.72,10.52,χ2 ＝9.04,all P ＜0.05).On the first day after operation ,the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin -6(IL-6) in the ERAS group were (28.3 ±4.9) μg／L and (23.1 ± 5.8)μg／L,respectively,which were lower than those in the traditional control group [(39.8 ±6.7)μg／L and (34.5 ± 8.1)μg／L](t＝8.76,7.24,all P＜0.05).The serum TNF-αand IL-6 levels in the ERAS group on the 3rd day after operation were (18.4 ±6.2) μg／L and (18.3 ±3.2) μg／L,respectively,which were lower than those in the traditional control group[(26.2 ±5.1)μg／L and (26.5 ±4.8) μg／L] ( t＝6.14,8.99,all P＜0.05).The serum levels of albumin (Alb) and prealbumin (PRE) in the ERAS group on the first day after operation were (31.1 ± 0.7)g／L and (161.3 ±7.2) mg／L,respectively,which were lower than those in the traditional control group [(30.2 ± 0.9)g／L and (154.3 ±4.8)mg／L](t＝4.99,5.12,all P＜0.05).The serum levels of Alb and PRE in the ERAS group on the 3rd day after operation were (33.4 ±0.5)g／L and (172.1 ±5.0)mg／L,respectively,which were lower than those in the traditional control group [(31.9 ±0.8) g／L and (165.3 ±3.2) mg／L] (t＝10.06,7.24,all P＜0.05).The WHOQOL-BREF score of the ERAS group[(91.4 ±6.5)points]was higher than that of the traditional control group[(80.3 ±7.8)points](P＜0.05).Conclusion Accelerated rehabilitation surgery has good effect for elderly gastric cancer surgery.It can maintain the inflammation and nutritional status of patients after operation .It is worthy of clinical reference.
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Objective To investigate the clinical efficacy of the curettage and aspiration technique in laparoscopic radical gastrectomy for the treatment of gastric cancer.Methods The clinical data of 55 patients who received laparoscopic radical gastrectomy by curettage and aspiration technique with Peng's multifunctional operative dissector at the Shaoxing People's Hospital from June 2008 to February 2011 were retrospectively analyzed.Tumors located at the upper stomach in 10 patients,at the middle stomach in 15 patients and at the lower stomach in 30 patients.The numbers of patients had tumor in TNM stage Ⅰ,Ⅱ,Ⅲ A were 16,35 and 4.Patients were followed up via phone call and out-patient examination till October 2013.Results Laparoscopic radical gastrectomy was successfully carried out on all the 55 patients.Of the 55 patients,39 received laparoscopic distal subtotal gastrectomy and 16 received laparoscopic total gastrectomy.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,distances of proximal and distal resection margins to the tumors,time to flatus,time to fluid diet and duration of postoperative hospital stay and incidence of postoperative complications were (241 ± 42)minutes,(273±115)mL,32 ±9,(5.8±1.4)cm,(5.1 ±l.7)cm,(78 ±24)hours,(95 ±17)hours,(12 ±4)days and 7.3％ (4/55),respectively.Two patients were complicated with pulmonary infection,1 with anastomotic fistula,1 with incisional infection,and all of them were cured by symptomatic treatment.No patients died perioperatively.All the 55 patients were followed up for 12.0-55.0 months,and the mean time of follow-up was 35.9 months.The cumulative 48-month survival rate was 54.8％.The postoperative recurrence and metastasis rate was 10.9％ (6/55).Peritoneal metastasis was detected in 2 patients,liver metastasis in 1 patient,para-aortic nodes metastasis in 1 patient,residual gastric metastasis in 1 patient,and bone metastasis in 1 patient.Conclusion Laparoscopic radical gastrectomy by curettage and aspiration technique is safe and feasible,with the advantages of minimal trauma,low morbidity and quick recovery.
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Objective To evaluate the effects of ginsenoside Rg3 combined with XELDX regimen on advanced carcinoma of stomach.Methods Totally 93 postoperative patients with advanced gastric cancer were randomly divided into two groups:control group(n ＝ 53) who received only XELDX regimen,and study group (n＝ 40) who were treated with ginsenoside Rg3 + XELDX.The objective response rate,KPS score and serum VEGF levels in the two groups were detected.Results (1) Before treatment,treatment group and control group showed that serum VEGF levels were (387.63±159.74) μg/L and (378.56± 169.36) μg/L,respectively (P＜0.05).After 8 weeks of treatment,serum VEGF of the treatment group decreased to (207.74 ± 115.71) μg/L,the level of the control group VEGF decreased to (246.53 ±107.63) μg/L(P＜0.05).(2) The efficacy rate was 57.5％ (23/40) in treatment group and 45.3％(24/53) in the control group (P＞0.05).(3) KPS score increasing rate was higher in treatment group (65.0％) than in control group (39.6％)(x2＝5.87,P＜0.05).Conclusions Ginsenoside Rg3 combined with chemotherapy in advanced gastric cancer patients can reduce serum VEGF levels and improve the quality of life of patients.