全腹腔镜远端胃癌根治术对胃癌患者术后免疫功能及并发症发生率的影响

The Effect of Total Laparoscopic Distal Gastrectomy on Postoperative Immune Function and Incidence of Complications in Gastric Cancer Patients

目的:探究全腹腔镜远端胃癌根治术(TLDG)对胃癌患者术后免疫功能及并发症发生率的影响。方法:选取我院2021年5月至2023年3月收治的80例胃癌患者,随机分为对照组与观察组,每组各40例。对照组采用腹腔镜辅助胃癌根治术(LADG),观察组采用TLDG。比较两组围术期指标、术后康复情况、免疫功能[T淋巴细胞亚群(CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))]、并发症发生率。结果:相较对照组,观察组的首次排气时间、住院时间较短,术中出血量较少(P<0.05);两组术后3d的CD4^(+)、CD4^(+)/CD8^(+)低于术前,但观察组高于对照组,两组CD8^(+)高于术前,但观察组低于对照组(P<0.05)。观察组并发症总发生率7.50%与对照组的12.50%比较,差异无统计学意义(P>0.05)。结论:LADG、TLDG均可治疗胃癌,安全性较高,但TLDG术中出血量较少,对免疫功能的影响较小,患者术后恢复较快。

Objective:To investigate the impact of total laparoscopic distal gastrectomy(TLDG)on postoperative immune function and incidence of complications in gastric cancer patients.Method:80 gastric cancer patients admitted to our hospital from May 2021 to March 2023 were randomly divided into a control group and an observation group,with 40 patients in each group.The control group received laparoscopic assisted radical gastrectomy(LADG),while the observation group received TLDG.Compare the perioperative indicators,postoperative recovery,immune function[T lymphocyte subsets(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+))],and incidence of complications between the two groups.Results:Compared with the control group,the observation group had shorter first exhaust time,hospital stay,and less intraoperative bleeding(P<0.05).The CD4^(+)and CD4^(+)/CD8^(+)levels at 3 days post surgery were lower than that before surgery in both groups,but the observation group was higher than the control group.The CD8^(+)levels in both groups were higher than that before surgery,but the observation group was lower than the control group(P<0.05).The total incidence of complications in the observation group was 7.50%compared to 12.50%in the control group,and there was no statistically significant difference(P>0.05).Conclusion:LADG and TLDG can both treat gastric cancer with high safety,but TLDG has less intraoperative bleeding and less impact on immune function,resulting in faster postoperative recovery for patients.