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Objective:To investigate the safety and efficacy of one-stage transurethral prostatectomy for prostatic hyperplasia accompanied by non-neurogenic detrusor acontractility.Methods:The clinical data of 35 patients with benign prostatic hyperplasia accompanied by non-neurogenic detrusor acontractility admitted to The Second Affiliated Hospital of Zhengzhou University from January 2015 to Octorber 2021 were analyzed.The average age was (74.0±7.9) years old. The average volume of prostate was (77.8±44.5)cm 3. The average total prostate specific antigen(tPSA)was(8.9±8.7)ng/ml. The preoperative international prostate symptom score(IPSS) was (19.1±4.3) and the preoperative quality of life score(QOL)was 5(5, 5). All the patients were treated with one-stage transurethral prostatectomy and suprapubic cystostomy. After removing the cystostomy tube, the post-void resident volume(PVR), the maximum urine flow rate(Q max), IPSS, QOL were recorded, and complications were followed up. Successful treatment is defined as the removal of the cystostomy tube without worsening of upper urinary tract hydronephrosis. Results:All the operations were successfully completed. The success rate of treatment was 85.7%(30/35), and the median time to resume spontaneous urination was 4.0(3.3, 4.5) weeks. The average postoperative Q max was (12.6±2.3)ml/s, and the average PVR was(27.7±9.5)ml. The postoperative IPSS was (5.5±2.4), which was significantly improved compared to preoperative( P<0.001). The postoperative QOL score was 1(1, 2) points, which was significantly lower than preoperative( P<0.001). The patients voiding spontaneously were followed up for 3-69 months, and no complications such as urinary retention, recurrent urinary tract infection and hydronephrosis occurred. Conclusions:One-stage transurethral prostatectomy for patients with benign prostatic hyperplasia accompanied by non-neurogenic detrusor acontractility has a high success rate and few complications, which greatly improves the quality of life of patients.
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Objective:To evaluate the strategy and skills of reoperation for recurrent carcinoma at the stoma of esophagojejunostomy after total gastrectomy.Methods:The management experience in 18 patients at the Department of General Surgery, Tumor Hospital of Zhengzhou University from Oct 2016 to Jul 2021 were analyzed retrospectively.Results:Thirteen patients underwent left thoracoabdominal combined incision to completely remove the tumor.One patient developed anastomotic leakage, two patients developed pulmonary infection, one patient developed costochondritis, all were cured and discharged after conservative treatment; Nine patients had no postoperative complications. Two patients abandoned surgery due to high position of the tumor, 3 patients due to poor cardiopulmonary function, and were given radiotherapy and chemotherapy.The postoperative follow-up period was 4.6 to 42.9 months. Four patients died of tumor recurrence, and the remaining patients survived until the end of the follow-up. The overall 1-and 3-year recurrence-free survival rates were 100% and 20%, respectively.Conclusion:Surgery on recurrent carcinoma at esophagojejunostomy stoma after total gastrectomy, although difficult and challenging,could still benefit most patients when at the hands of expertise.
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Objective To explore the safety and efficacy of middle line approach identified with superior mesenteric vein in the right hemicolectomy combined with pancreaticoduodenectomy for colonic carcinoma involing liver and duodenun.Methods Clinical data of 13 patient's with right colonic cancer (T4b) undergoing right hemicolectomy combined with pancreaticoduodenectomy from Jan 2016 to Jul 2019 in He'nan Provincial Tumor Hospital were retrospectively analyzed.The superior mesenteric vein was used to mark the medial border of tumor resection.Vertical cutline was made to transverse mesocolon and all the way done to the root of superior mesenteric vein,the pancreas was cut in front of superior mesenteric vein,superior mesenteric artery and the affiliated lymph nodes were dissected.The stomach and pancreas were transected,the specimen was removed.Then the GI tract was reconstructed.Results Surgery was successful in all 13 patients.The operation time was (249 ± 27) min,blood loss was (442 ± 129) ml,2 cases suffered pancreatic fistula,there was no biliary fistula,and 1 case of delayed gastric emptying.There were no other major complications.The number of lymph node dissection was (20 ± 4) and hospital stay was (23.2-± 9.4) d.Conclusions It is safe and feasible to use the superior mesenteric vein-identified middle line approach in patients of right colonic cancer undergoing right hemicolectomy plus pancreaticoduodenectomy.
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Objective@#To evaluate surgical repair of vesicorectovaginal fistula using transvaginal pedicled omentum pull-through combined transanal colon pull-through.@*Methods@#A total of 11 patients with postoperative vesicorectovaginal fistulas complicating female reproductive system malignant tumors undergoing repairement from Aug 2013 to Aug 2018 were retrospectively analyzed. In order to isolate, protect the bladder and eliminate residual vaginal cavity using transvaginal pedicled omentum pull-through, combined transanal colon pull-through to repair vesicorectovaginal fistula.@*Results@#All the 11 patients in this group completed the operation successfully, and no air or stool passing from the vaginal after the operation. The fistula disappeared in five patients confirmed by cystography and enterograph. The average operation time was 115 min, the average blood loss was 260 ml.Incision fat liquefaction was found in two. Incision infection occurred in one. Urinary dysfunction in two. Anal stenosis was found in four patients which were healed by anal dilation.@*Conclusions@#Transvaginal pedicled omentum pull-through combined transanal colon pull-through can eliminate vesicorectovaginal fistula, improve life quality and avoid colostomy.
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Objective To evaluate surgical repair of vesicorectovaginal fistula using transvaginal pedicled omentum pull-through combined transanal colon pull-through.Methods A total of 11 patients with postoperative vesicorectovaginal fistulas complicating female reproductive system malignant tumors undergoing repairement from Aug 2013 to Aug 2018 were retrospectively analyzed.In order to isolate,protect the bladder and eliminate residual vaginal cavity using transvaginal pedicled omentum pull-through,combined transanal colon pull-through to repair vesicorectovaginal fistula.Results All the 11 patients in this group completed the operation successfully,and no air or stool passing from the vaginal after the operation.The fistula disappeared in five patients confirmed by cystography and enterograph.The average operation time was 115 min,the average blood loss was 260 ml.Incision fat liquefaction was found in two.Incision infection occurred in one.Urinary dysfunction in two.Anal stenosis was found in four patients which were healed by anal dilation.Conclusions Transvaginal pedicled omentum pull-through combined transanal colon pull-through can eliminate vesicorectovaginal fistula,improve life quality and avoid colostomy.
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Objective To explore the role of lung dendritic cells (DCs) and Th17/regulatory T cells (Treg) pathway in the pathogenesis of chronic obstructive pulmonary disease(COPD).Methods COPD patients who received lobectomy from Sep.2015 to Mar.2016 in our hospital were enrolled and classified into non-smoking non-COPD group,smoking without COPD group and COPD group.The expression of CD80,chemokine recepter-6 (CCR6),interleukin-17A (IL-17A) and fork-head transcription factor P3 (FoxP3) were detected by immunohistochemistry (IHC) in lung tissue.Mature DCs (mDCs),immature DCs (imDCs),Th17 cells and Treg cells in lung tissue were detected by flow cytometry (FCM) and the correlation between Th17/ Treg cells with lung function was analyzed.Results (1) The expression of CD80 and FoxP3 in COPD group was decreased,while the expression of CCR6 and IL-17A was increased (P＜0.05).(2) The percentage of mDCs and Treg in lung tissue of COPD group was significantly decreased.In contrast,the proportion of imDCs and Th17 cells in COPD group was significantly increased (P＜0.05).(3) The imbalance of Th17/Treg ratio in lung tissue was seen in patients with COPD,suggesting the potential mechanism of Th17 cell-mediated proinflammatory response.(4) The percentage of Th17 cells and Th17/Treg ratio in COPD patients was negatively correlated with forced expiratory volume in the first second (FEV1) as a percentage of predicted value (FEV1％ pred),forced vital capacity(FVC) as a percentage of predicted value (FVC％ pred),FEV1/FVC.On the other hand,the percentage of Treg cells was positively correlated with FEV1％ pred,FVC％ pred,FEV1/FVC.Conclusions The data in this study demonstrate the maturation disorder of dendritic cells in lung tissue of COPD patients.The imbalance of Th17/Treg ratio suggests that Th17 cell-mediated proinflammatory response may be involved in the pathogenesis of COPD.
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Objective To investigate the application value of the curved cutter stapler device combined with trans-orally inserted anvil (OrVil) in the radical resection of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 206 patients with Siewert type Ⅱ AEG who were admitted to the Henan Tumor Hospital between March 2011 and March 2016 were collected.All the 206 patients underwent radical resection and 3-step clock wise total gastrectomy + D2 lymph node dissection.Observation indicators:(1) surgery and postoperative recovery situations:surgical approach,overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,postoperative complications and duration of postoperative hospital stay;(2) postoperative pathological examination and chemotherapy;(3) follow-up and survival situations.Follow-up using telephone interview and outpatient examination was performed to detect tumor-free survival of patients up to April 2016.Measurement data with normal distribution were represented as x±s.The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgery and postoperative recovery situations:all the 206 patients received successful operations,including 85 with abdominal operation,50 with abdominal incision through the diaphragmatic muscle into thoracic surgery and 71 with thoracic-abdominal surgery.Overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation and duration of hospital stay were (113.7± 15.4)minutes,(3.5± 1.2)minutes,(10.4±2.9)minutes,(128±25) mL,32± 6,(2.4 ± 0.9) days and (12.3 ± 1.9) days,respectively.Of 206 patients,15 with postoperative complications were cured by conservative treatment,including 6 with implicit anastomotic fistula,3 with dominant anastomotic fistula,2 with pancreatic leakage,2 with intestinal obstruction,1 with anastomotic stenosis and 1 with thoracic and abdominal infection.There was no reoperation due to perioperative complications.(2) Postoperative pathological examination and chemotherapy:postoperative pathological results showed that distance from resection margin of the esophagus to tumor was (5.2±0.4) cm,without cancer cells in the resection margin.Among 206 patients,171 received postoperative chemotherapy by S1 single agent combined with oxaliplatin for 6-8 cycles or oral S1 single agent for 1 year.(3) Follow-up and survival situations:206 patients were followed up for (2.7± 0.3)years,with a tumor-free 3-year survival rate of 58％.During the follow-up,there was no recurrent anastomotic tumor.Conclusion The curved cutter stapler device combined with OrVil in the radical resection of Siewert type Ⅱ AEG can simplify the difficulty of esophagojejunal anastomosis and guarantee the safe resection margin of the lower esophagus.
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Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.
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Objective To explore the risk factors of ulcerative colitis-associated colorectal cancer (UC-CRC).Methods The retrospective case-control study was conducted.The clinicopathological data of 536 patients with ulcerative colitis (UC) who were admitted to the Henan Tumor Hospital from March 2004 to June 2015 were collected.Observation indicators:(1) follow-up results:cases with follow-up,follow-up time,cases of UC-CRC,age of onset,pathological type of UC-CRC;(2) risk factors analysis affecting occurrence of UC-CRC:gender,age of onset,course of disease,severity of disease,disease classification,extent of lesion,smoking history,family history of colorectal cancer,anemia,hypoproteinemia,body weight loss,extraintestinal manifestations,colonic polyps,backwash ileitis,atypical hyperplasia,anxiety or depression,treatment method and regular endoscopy reexamination.Follow-up using outpatient examination and telephone interview was performed to detect prognosis of patients up to April 2017.Patients underwent colonoscopy once every 6 months within 3 years after diagnosis and once every 1 year after 3 years.Measurement data with skewed distribution were described as M (range).The univariate analysis was done using the chi-square test and Fisher exact probability.The multivariate analysis was done using the Logistic regression model.Results (1) Follow-up results:of 536 patients,450 were followed up for 26.0-120.0 months,with a median time of 76.4 months.During the follow-up,16 patients were complicated with UC-CRC,including 9 males and 7 females.Age of onset of colorectal cancer was 14-78 years,with an average age of onset of 44 years.Pathological type:high-differentiated right colon adenocarcinoma was detected in 5 patients,high-and moderate-differentiated left colon adenocarcinoma in 3 patients,left colon signetring cell carcinoma in 2 patients,moderate-differentiated rectal tubular adenocarcinoma in 3 patients,highdifferentiated rectal papillary adenocarcinoma in 2 patients and malignant lymphoma in 1 patient.(2) Risk factors analysis affecting occurrence of UC-CRC:the results of univariate analysis showed that course of disease,extent of lesion,colonic polyps and atypical hyperplasia were risk factors affecting occurrence of UC-CRC (x2 =14.848,18.885,10.554,P＜0.05).The results of multivariate analysis showed that course of disease ＞ 10 years,lesion involving the whole colon,colonic polyps and atypical hyperplasia were independent risk factors affecting occurrence of UC-CRC (OR=12.893,17.847,7.326,19.742,95％ confidence interval:1.726-74.337,1.445-89.793,1.263-43.128,3.625-96.524,P＜0.05).Conclusion The course of disease ＞ 10 years,lesion involving the whole colon,atypical hyperplasia and colonic polyps are independent risk factors affecting occurrence of UC-CRC.
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<p><b>OBJECTIVE</b>To explore the application of three-stitch preventive transverse colostomy in anterior resection of low rectal cancer.</p><p><b>METHOD</b>From May 2015 to March 2016, 70 consecutive low rectal cancer patients undergoing anterior resection and preventive transverse colostomy in our department were recruited in this prospective study. According to the random number table method, 70 patients were divided into three-stitch transverse colostomy group(observation group, n=35) and traditional transverse colostomy group(control group, n=35). Procedure of three-stitch preventive transverse colostomy was as follows: firstly, at the upper 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from outside to inside, then the needle belt line went through the transverse edge of the mesangial avascular zone. At the lower 1/3 incision 0.5-1.0 cm distance from the skin, 7# silk was used to suture from inside to outside, then silk went through the transverse edge of the mesangial avascular zone again and was ligatured. Finally, in the upper and lower ends of the stoma, 7# silk was used to suture and fix transverse seromuscular layer and the skin. The operation time and morbidity of postoperative complications associated with colostomy were compared between two groups.</p><p><b>RESULTS</b>There were no significant differences in baseline data between the two groups(all P>0.05). The operative time of observation group was shorter than that of control group [(3.2±1.3) min vs. (15.5±3.4) min, P<0.05]. Incidences of colostomy skin-mucous separation, dermatitis, stoma rebound were significantly lower in observation group [5.7%(2/35) vs. 34.3%(12/35), P=0.007; 8.6%(3/35) vs. 31.4%(11/35), P=0.036; 0 vs. 17.1%(6/35), P=0.025, respectively], while incidences of parastomal hernia and stoma prolapse in two groups were similar (both P>0.05).</p><p><b>CONCLUSION</b>Compared with traditional transverse colostomy method, the three-stitch preventive transverse colostomy has more operating advantages and can reduce postoperative complications associated with colostomy.</p>
Subject(s)
Humans , Colostomy , Methods , Comparative Effectiveness Research , Operative Time , Postoperative Complications , Epidemiology , Prospective Studies , Rectal Neoplasms , General Surgery , Surgical Stomas , Suture Techniques , Sutures , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To explore the technical advantages of nano carbon development combined with artery approach in lymph node sorting of rectal cancer.</p><p><b>METHODS</b>From December 2015 to June 2016, 70 patients with of rectal cancer in General Surgery Department of Henan Cancer Hospital were randomly divided into nano carbon development combined with artery approach group(artery approach group) and conventional group. Specimen of artery approach group was placed on the sorting table. Anatomy was performed from the root of inferior mesenteric artery to left colonic artery, sigmoid artery and superior rectal artery. Along the arterial vessel shape, the black-stained lymph nodes and non-stained lymph nodes (perhaps pink, pale yellow, white or pale brown) were examined carefully using visual and haptic combination method for identification of lymph node. From the root of inferior mesenteric artery, central lymph nodes were sorted. Along the vessel shape, vascular lymph nodes were sorted. Intestinal lymph nodes around the rectum were examined as well. Then, specimen was reversed on the sorting table and underwent sorting as above after the examination of obverse. The conventional group received routine method. The total number, the average harvested number, the number of positive lymph nodes and the number of patients with lymph nodes less than 12 were compared between two groups.</p><p><b>RESULTS</b>Among 70 cases, 37 were male and 33 were female with the median age of 57(32-88) years old. Dixon resection was performed in 46 cases, and Miles resection in 24 cases. Total sorting lymph node was 1 105, including 641 of artery approach group and 464 of control group with significant difference (t=20.717, P=0.000). Lymph node sorting time of artery approach group was (12.6±3.9) minutes, which was shorter than (18.2±4.1) minutes of control group (t=12.464, P=0.000). In artery approach group, number of lymph node with diameter less than 5 mm was 142, sorting rate was 22.2%(142/641), of which 29 were positive(20.4%). In conventional group, 37 lymph nodes with diameter less than 5 mm were found, and sorting rate was 8.0%(37/464), of which 6 were positive(16.2%). Number of the first station of lymph node sorting in artery approach group and conventional group was 282(44%) and 169(36.4%); number of the second station lymph node sorting was 230(35.9%) and 180(38.8%); number of the third station lymph node sorting was 129(20.1%) and 115(24.8%).</p><p><b>CONCLUSION</b>The method of nano carbon development combined with artery approach in lymph node sorting of rectal cancer has some advantages, such as simple operation, more harvested lymph nodes, and more accurate pathological staging.</p>
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Objective To explore the surgical approach of retroperitoneal giant tumors not crossing the midline.Methods We retrospectively analyzed the clinical data of 60 cases of resected giant retroperitoneal tumors (diameter ＞ 10 cm) totally located one-sided of the obdominal cavity from September 2010 to May 2016 in Henan Cancer Hospital.Results Fifty-nine patients underwent successful resection of the tumor,the average operation time was (110 ± 13) min,with an average bleeding volume of (635 ± 22) ml.One patient died of postoperative intra abdominal bleeding.32 cases died during the follow-up for tumor recurrence.The median survival time was 63 months,and the survival rates of the patients at 1,3,and 5 years were 96％,80％,and 54％.Conclusion For large retroperitoneal tumors within one side of the midline,appropriate surgical approach and surgical strategy can reduce the operation time and improve the operation safety.
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Objective To study the reason and the preventive measures that adverse effects of extracorporeal shockwave lithotripsy (ESWL) for renal stones during treatment.Methods From April 2015 to January 2016,165 patients who underwent ESWL treatment for renal stones were enrolled this retrospective study.All patients were in supine position.Direction of shockwave was by the path of preabdomen.The adverse effects during treatment were observed.The related factors were analyzed by Logistic regression analysis.Results There were 70 cases(42.4％) with pain,10 cases(6.1％) with cold sweat,8 cases (4.8％) with accelerated heart rate,5 cases (3.0％)with descent of heart rate,2 cases (1.2％) with nausea and vomiting.In the univariate Logistic regression analysis,four variables (BMI,history of ESWL treatment,stone location and energy) were found showing statistical significance.Multivariate Logistic regression analysis showed that the final significant related factors were BMI ＜ 24.0 kg/m2 (OR =4.155,CI 1.373-12.571),history of ESWL treatment (OR =0.163,CI 0.058-0.454),stone in pelvis(OR =123.051,CI 17.638-858.439),stone in middle calyceal (OR =169.171,CI 29.677-964.343),energy 86.3-94.7J (OR =0.094,CI 0.025-0.362).Conclusions Pain was the most common adverse effect during the treatment of ESWL.Stone location (pelvis and middle calyceal) was an independent risk factor,BMI ＜ 24.0 kg/m2 was one of the related risk factors.Both energy 86.3-94.7J and history of ESWL treatment were preventive factors.
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Objective To compare the quality of life,nutritional status,and immune function after radical proximal gastrectomy,radical total gastrectomy,or radical distal gastrectomy.Methods Totally 163 patients underwent radical gastrectomy for gastric cancer in our department from Jun 2002 to Jun 2008,among whom 36 cases underwent proximal gastrectomy,and 78 cases underwent total gastrectomy,and 49 cases underwent distal gastrectomy.The indicators for their quality of life,nutritional status,and immune function were compared among these three groups.Results The scores for anxiety was significantly higher in the radical proximal gastrectomy group compared with radical total gastrectomy and radical distal gastrectomy groups 1 year(79.8 ± 4.3 vs 72.2 ± 5.2and 70.6±5.5,P=0.037)and 2 years(80.3 ±4.4 vs 70.2±4.8 and 68.6±5.3,P=0.041)after surgery.The scores for the sense of taste was significantly higher in the radical total gastrectomy group compared with radical proximal gastrectomy and radical distal gastrectomy groups 1 year(82.6 ± 1.3 vs 71.1 ±4.8 and 72.3 ± 3.6,P =0.033)and 2 years(88.1 ± 3.4 vs 65.6 ± 5.2 and 69.6 ± 4.8,P =0.046)after surgery.The scores for body appearance was significantly higher in the radical total gastrectomy group compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years(45.5 ± 2.4 vs 35.6 ± 2.2 and 33.3 ± 2.5,P =0.031),1 year(49.2 ± 1.9 vs 33.2 ±2.8 and 32.7 ±2.3,P =0.039),and 2 years(47.6 ±2.5 vs 32.4 ±4.0 and 30.0 ± 2.2,P =0.025)after surgery.The scores for dysphagia was significantly lower in the radical distal gastrectomy group compared with radical proximal gastrectomy group and radical total gastrectomy group 1 year (26.6±3.0vs38.1±2.2 and 35.1 ±2.3,P=0.043)and 2 years(17.3±2.5 vs 36.3±3.1 and 34.1 ±2.4,P =0.021)after surgery.The scores for stomach pain was significantly higher in the radical proximal gastrectomy group compared with radical total gastrectomy 0.5 years(41.2 ± 3.3 vs 37.1 ± 2.5,P =0.039),1year(38.1±2.2vs35.1±2.2,P=0.023),2 years(36.3±3.1 vs 34.1±2.4,P=0.034)after surgery.Radical distal gastrectomy group were significantly lower than those in radical proximal gastrectomy group and radical total gastrectomy group 0.5 years(38.6 ± 3.7 vs 55.3 ± 4.2 and 42.3 ± 3.9,P =0.034),1 year(35.4 ± 3.4 vs52.3 ±3.9 and 39.3 ±4.2,P=0.040),and 2 years(31.6±3.7 vs 53.3 ±4.2 and 35.5 ±3.7,P=0.011)after surgery.Radical proximal gastrectomy group compared with radical total gastrectomy,0.5 years(55.3 ± 4.2vs 42.3±3.9,P=0.036),1 year(52.3±3.9 vs 39.3±4.2,P=0.042),2 years(53.3±4.2 vs 35.5±3.7,P =0.019)after surgery,the difference has statistically significant.The scores for hiccup was significantly lower in the radical distal gastrectomy group compared with radical proximal gastrectomy group and radical total gastrectomygroup,0.5 years(16.8±3.3 vs 45.6±2.5 and 40.3±2.8,P=0.019),1 year(15.6±3.4 vs 40.7±2.3 and 36.5 ± 3.1,P =0.025),2 years(14.4 ± 2.6 vs 39.3 ± 1.9 and 35.6 ± 3.2,P =0.042)after surgery.Radical proximal gastrectomy group compared with radical total gastrectomy 0.5 years(45.6 ± 2.5 vs 40.3 ± 2.8,P=0.039),1 year(40.7±2.3 vs 36.5±3.1,P=0.019),2 years(39.3±1.9 vs 35.6±3.2,P=0.028)after surgery,the difference has statistically significant.In the restricted diet,the radical distal gastrectomy group had significantly lower scores compared with radical proximal gastrectomy group and radical total gastrectomy group 0.5 years(22.4 ±3.8 vs 38.4 ±2.3 and 42.1 ±3.1,P=0.020),1 year(18.7 ±2.3 vs 35.3 ±3.2 and 36.8 ±3.4,P =0.018),and 2 years(16.5 ± 2.7 vs 33.4 ± 2.7 and 32.4 ± 2.8,P =0.026)after surgery.The level of albumin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(30.6 ± 2.5)vs(34.3 ± 2.6)and(35.4 ±2.5)g/L,P=0.025],1 year[(32.4±2.1)vs(35.3 ±2.2)and(38.9 ±2.0)g/L,P=0.041],2 years [(32.1 ±2.4)vs(36.4 ±2.1)and(42.4 ±2.3)g/L,P=0.016]after surgery.The level of prealbumin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(209.1 ±5.7)vs(218.2 ±5.9)and(225.5 ±7.6)mg/L,P =0.030],1 year[(215.5 ±4.6)vs(223.1±3.7)and(236.1 ±4.4)mg/L,P=0.019],2 years[(216.1 ±3.1)vs(221.5 ± 4.3)and(240.5 ± 5.6)mg/L,P =0.024)]after surgery.The level of transferrin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(153.1 ± 3.2)vs(167.9 ± 2.4)and(170.3 ± 3.8)mg/L,P =0.017],1 year[(157.1 ±3.8)vs(169.4±2.2)and(175.4±3.7)mg/L,P=0.040],2 years[(156.4±2.7)vs(173.1 ± 1.8)and(174.1 ±2.8)mg/L,P =0.031]after surgery.The level of hemoglobin in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(109.5 ± 4.6)vs(120.2 ± 2.7)and(122.6 ± 3.9)g/L,P =0.016],1 year[(103.6±2.9)vs(117.5 ±16.6)and(125.2±1.5)g/L,P =0.030],2 years[(105.5 ±1.6)vs(106.6 ± 2.9)and(132.6 ± 2.9)mg/L,P =0.028]after surgery.The level of retinol binding protein in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 years[(32.3 ± 2.1)vs(167.9 ± 2.4)and(37.6 ± 2.8)mg/L,P =0.013],1 year[(33.9 ± 1.6)vs(39.3 ±2.5)and(38.5 ±3.5)mg/L,P=0.009],2 years[(35.3 ±2.7)vs(38.9 ± 1.4)and(39.1 ±2.3)mg/L,P =0.034]after surgery.The weight in different periods was significantly higher in radical distal gastrectomy groups compared with radical proximal gastrectomy and radical total gastrectomy group 0.5 years[(63.4±2.5)vs(60.7 ±3.2)and(59.4±1.1)kg,P=0.017],1 year [(66.1 ±3.7)vs(59.4±2.1)and(56.4±6.1)kg,P=0.028],2 years[(67.4 ±4.1)vs(57.4 ±4.1)and(53.3 ± 2.4)kg,P =0.035]after surgery.The level of CD4 + in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy groups 0.5 years(30.46 ±4.45 vs 33.32 ±5.6 and 34.24 ±2.54,P =0.036),1 year(32.84 ± 3.61 vs 35.30 ±4.27and 35.49±3.01,P=0.025),and 2 years(31.61±4.04 vs36.24±4.71 and 37.74±4.15,P=0.030)after surgery.Also,the radical total gastrectomy group had significantly lower CD8 + than radical proximal gastrectomy and radical distal gastrectomy groups 0.5 year(24.16 ± 5.07 vs 24.12 ± 5.9 and 25.25 ± 3.54,P =0.036),1 year(32.84 ±3.61 vs 35.30 ±4.27 and 35.49 ±3.01,P =0.025),and 2 years(31.61 ±4.04 vs36.24 ±4.71 and 37.74 ±4.15,P =0.030)after surgery.The level of IgM in different periods was significantly lower in radical total gastrectomy groups compared with radical proximal gastrectomy and radical distal gastrectomy group 0.5 year(1.20 ±0.17 vs 1.36 ±0.22 and 1.41 ±0.27,P =0.026),1 year(1.25 ±0.14 vs 1.38 ±0.19 and 1.40 ± 0.15,P =0.037),and 2 years(1.29 ± 0.17 vs 1.39 ± 0.16 and 1.42 ± 0.13,P =0.017)after surgery.Also,the radical total gastrectomy group had significantly lower IgA than radical proximal gastrectomy and radical distal gastrectomy groups 0.5 year(2.03 ± 0.21 vs 2.47 ± 0.32 and 2.43 ± 0.25,P =0.020),1 year(2.14 ±0.21 vs 2.64 ±0.23 and 2.52 ±0.17,P =0.025),and 2 years(2.25 ±0.19 vs 2.63 ±0.18and 2.74 ± 0.16,P =0.033)after surgery.Conclusion The distal gastrectomy may have better quality of life,nutrititional status,and immune function than the proximal gastrectomy and total gastrectomy,whereas the latter two procedures also have certain advantages.