Effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress, immune responses and intestinal barrier function in elderly patients with esophageal cancer / 中华老年医学杂志

ABSTRACT

Objective To analyze the effects of laparoscope-assisted Ivor-Lewis surgery on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.Methods A prospective study including 55 elderly esophageal cancer patients undergoing laparoscope-assisted Ivor Lewis surgery (the treatment group,n =25) and Ivor-Lewis surgery(the control group,n=25) was conducted.The white blood cell count,neutrophil-to-lymphocyte ratio,percentages of CD4 and CD8 cells,CD4/CD8 ratio,C reactive protein (CRP) and D-lactic acid levels were compared between the two groups before and at 1,4 and 7 d after operation.Results The white blood cell count(t =2.689,P =0.010) and neutrophil-to-lymphocyte ratio (t =3.300,P =0.002)were lower in the treatment group than in the control group at 1 d after operation.The percentage of CD4 cells was higher in the treatment group than in the control group at 1 d(t =2.242,P =0.029)and 4 d(t =2.031,P =0.047) after operation.The percentage of CD8 cells was higher in the treatment group than in the control group at 1 d after operation(t =2.041,P=0.046).The CD4/CD8 ratio was higher in the treatment group than in the control group at 1 d(t =2.833,P =0.007)and 4 d(t=2.111,P=0.036)after operation.The CRP level was lower in the treatment group than in the control group at 1 d(t=2.267,P=0.028)and 4 d(t =2.111,P =0.036)after operation.The D-lactic acid level was lower in the treatment group than in the control group at 1 d(t =2.267,P=0.028),4 d (t =7.967,P ＜ 0.01) and 7 d (t =2.541,P =0.014) after operation.Conclusions Laparoscopeassisted Ivor-Lewis surgery has good protective effects on perioperative stress,immune responses and intestinal barrier function in elderly patients with esophageal cancer.