ABSTRACT
Objective To analyze the effect of laparoscopic minimally invasive surgery on the immune function of patients with gastric cancer and its clinical efficacy.Methods A total of eighty patients with gastric cancer treated in the First Affiliated Hospital of Hainan Medical University from February 2012 to February 2017 were retrospectively selected.According to the different surgical methods the patients were divided into laparoscopic group and laparotomy group.The laparotomy group was treated with open radical gastrectomy,and the laparoscopic group was treated with laparoscopic radical gastrectomy.The operation and postoperative condition,complications,immune indexes and changes of gastrointestinal hormone levels in the two groups were observed.Results The operation time of the endoscopic group was(198.64±43.89)min,longer than that in the laparotomy group((152.01 ± 42.11)min),the incision size((5.79 ± 1.54)cm),blood loss((75.20 ±11.36)ml)and hospitalization time((8.12±1.58)d)were less than those in the control group((15.96 ±1.55)cm,(129.21±12.03)ml,(12.33±1.85)d)(t=4.849,29.428,20.645,10.944; P<0.05).There was no significant difference in the number of lymph node dissection between the two groups(P>0.05).The CD3,CD4,CD8 and CD4 /CD8 in the laparotomy group three days after the treatment were lower than those after treatment in the endoscopic group((51.90 ± 3.66)% vs.(62.01 ± 3.02)%;(30.25 ± 3.98)% vs.(41.13 ±4.79)%;(23.01±4.02)% vs.(28.20 ± 4.15)%;(0.93 ± 0.21)% vs.(1.19 ± 0.20)%)(t=13.475, 11.049,5.681,5.670,P<0.05).No significant difference was showed between the levels of immune indexes before and after treatment in the endoscopic group(P>0.05).The VIP in the laparotomy group 3d after the treatment was higher than those before treatment and in the laparoscopic group after treatment,MTL and SS were lower than those before treatment and in the endoscopic group after treatment(t=1.707,2.713,4.409,1.756, 2.488,3.969;P<0.05).There was no significant difference in the levels of gastrointestinal hormones before and after treatment in the endoscopic group(P>0.05).The complication rate in the endoscopic group was 10% and 27.50% in the laparotomy group,and the complication rate in the endoscopic group was lower than that in the laparotomy group(χ2=4.021;P<0.05).Conclusion Laparoscopic radical gastrectomy has the advantages of less trauma,less bleeding loss and less complications.It also has little effect on the immune function and gastrointestinal hormones,which is beneficial to the recovery of postoperative patients.