Comparison Of Laparoscopy Radical Gastrectomy And Open Radical Gastrectomy Effect On The Body’s Stress Response

Object:In this study, we will discuss and evaluate the effects on the body’s stress response of laparoscopy radical gastrectomy(LRG) and its advantages, by analyzing the clinical data of patients with LRG and open radical gastrectomy(ORG), so that provide a strong reference to the promotion of laparoscopy radical gastrectomy for further.Materials and Medthods:Select30patients who had been diagnosed with stomach cancer and need radical surgery in our department between June and December in2013, and randomly divide them into LRG group and ORG group with each group15patients. The patients’ fasting blood was collected one day before the operation, and an hour, one day, two days and five days after the operation to detect the levels of tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6), C-reactive protein(CRP), growth hormone releasing peptide ghrelin(GHRP-Ghrelin) and heme oxygenase-1(HO-1) in the serum by enzyme-linked immunosorbent assay(ELISA). Besides, the general information, operation associated data and postoperative recovery associated data of patients in two groups were collected and recorded. And then those data was analyzed by statistical software to get the results.Results:1.There are no significant statistical differences between LRG group and ORG group in gender, age, weight (P>0.05). The operative time of LRG group(255.33± 38.75minutes) is significantly longer than ORG group(192.67±20.86minutes)(P<0.05), but the surgical blood loss of LRG group(121.67±27.49ml) is less than ORG group(201.33±36.13ml)(P<0.05); the length for incisions of LRG group (7.47±0.97cm) is shorter than ORG group(19.90±1.63cm)(P<0.05); the time for first flatus of LRG group(2.11±0.33days) is shorter than ORG group(2.78±0.47days)(P<0.05); the time for first ambulation of LRG group(2.52±0.41days) is shorter than ORG group(3.24±0.49days)(P<0.05); the time for postoperative hospital stay of LRG group(9.73±1.91days) is shorter than ORG group(11.73±1.83days)(P<0.05); there are no significant differences in complication rate between LRG group(2cases) and ORG group(3cases)(P>0.05).2.There are no significant differences between LRG group and ORG group in the levels of TNF-a, IL-6, CRP, Ghrelin and HO-1in the serum on the day1before the operation (P>0.05). And all the levels of them increase after the operation. For TNF-a and CRP, the serum levels in an hour after operation show no significant differences between the two groups (P>0.05), and the serum levels of LRG group are significant lower than ORG group on the day1, day2and day5after operation (P<0.05). For IL-6and Ghrelin, the serum levels of LRG group are significant lower than ORG group in an hour, on the day1, day2and day5after operation (P<0.05). The serum levels of HO-1show no statistical differences between the two groups (P>0.05).Conclusions:1.Compared with ORG, there are no significant differences in the effects of LRG on the serum levels of HO-1, but LRG has smaller effects on the levels of TNF-a, IL-6, CRP, Ghrelin, which shows in some measure that LRG causes less stress response.2.LRG needs a slightly longer operative time, but it causes less trauma on the body, less blood loss, faster postoperative recovery and shorter time for hospital stay.3.LRG shows a clear advantage, so it is worthy of further development and research.4.But the persuasion of this study is not strong enough with a small number of patients and a single experimental method. So it can be researched on for further to find more evidence.