Résumé
The strategies for prevention and treatment of recent complications after radical gastrectomy should be of equal emphasis on both theory and technology.Systematic prevention is the fundamental strategy,and adequate preoperative assessment and preparation are the basis.A reasonable extension of the radical gastrectomy and standard and refined surgical procedures could reduce the occurrence of complications.In addition,identifying these complications timely and taking effective treatments promptly according to the clinical context are the keys to reducing the treatment cycle and decreasing the mortality.
Résumé
Objective Our retrospective study is aimed to discuss the relationship between the curve changes of T lymphocyte subsets before and after the operation and the infectious complications after radical resec -tion of gastric cancer .Methods Clinical data of patients with gastric cancer received treatment at Central Hospi -tal of Panjin City,Liaoning Province from 2012 to 2014 were retrospectively analyzed .The enrolled patients were divided into two groups according to the infectious complications ,observe group ( patients with infectious complica-tions) and control group ( patients without infectious complications ) .The results of T lymphocyte subsets in two groups were compared .Results A total of 70 patients was retrospective analyzed , including 33 pationts in ob-serve group and 37 pationts in control group.At the 4th day after operation,the levels of CD3,CD4 in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points . At the 4th and 9th day after operation,the levels of CD8,CD4/CD8 rate in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points .Conclusion There is re-markable relationship between the curve changes of T lymphocyte subsets before or after the operation and the in -cidence of infectious complications after radical resection of gastric cancer .
Résumé
Objective To explore the optimal method of anesthesia in radical resection of gastric cancer by comparing the effects of two anesthesia techniques on the balance of Th1/Th2 in order to provide evidence for clinical anesthesia manage-ment.Methods Forty patients who underwent elective radical resection of gastric cancer were randomized into two groups:in-halation anesthesia group(group S)and total intravenous anesthesia group(group P),in which sevoflurane and propofol were ad-ministered for the induction and maintenance of anesthesia,respectively.The general data of the patients were collected,the tis-sue type of tumors obtained and the fluid infusion and blood loss volumes recoded.The VAS score was obtained 1 h,6 h and 5 d after the surgery.Before the induction of anesthesia,6 h and 5 d after surgery,the blood samples were drawn to determine the serum levels of IL-1β,IFN-γ,TNF-α,IL-2,IL-6 and IL-10.Flow cytometry was used to detect the proportion of CD3+CD8-IFN-γ+ and CD3+CD8-IL-10+ cells and the Th1/Th2 ratio was calculated.Results The level of IL-6 was increased post-sur-gically in groups S and P(P0.05).The levels of TNF-αand IFN-γ,and the Th1/Th2 ratio were significantly increased in group P 5 d after the surgery(P<0.05).Conclusion Total intravenous anesthesia with propofol can enhance Th1 response and it is an ideal anesthetic method for radical resection of gastric cancer.