Comparative Study Of Stress And Oxidative Stress Markers After Laparoscopic And Conventional Pancreaticoduodenectomy On Pancreas Head Cancer

Objective:Pancreatic head cancer is one of the most common malignant tumors of digestive tract.With the change of people's diet and living habits,the incidence of pancreatic head cancer increased year by year.From the current situation at home and abroad,Comprehensive treatment of radical pancreaticoduodenectomy is the primary choice to cure pancreatic head cancer.The operation was performed with the principle of no tumor,adequate resection,safe resection and lymph node dissection.With the development of minimally invasive surgery,The clinical practice of LPD in the treatment of pancreatic head cancer is becoming more and more popular and still in the exploratory stage.For this reason,our department of minimally invasive surgical choose LPD as the research subject.By testing?comparing and analysying the effect of operation?the level of systemic stress and oxidative stress markers in patients after laparoscopic and conventional pancreaticoduodenectomy on Pancreatic head cancer so as to provide a theoretical reference for clinical practice.Methods:Clinical data of 48 patients undergoing pancreaticoduodenectomy in Minimally Invasive Surgery of The second hospital of LanZhou university from October 2014 to October 2016 were analyzed using the methodology of prospective non-randomized comparison according to the preferred surgical method of the patients or clients,of which 24 underwent laparoscopic Pancreaticoduodenectomy(LPD group)and 24 patients underwent open pancreaticoduodenectomy(OPD group).Record and compare the operation time,blood lose,hospitalization time,postoperative exhaust time and complications respectively.The serum stress hormones(cortisol,adrenaline,noradrenaline,angiotensin ?)and oxidative stress indexes(reactive oxygen,superoxide dismutase,glutathione peroxidase and total antioxidant capacity)of two groups before the operation and at different times after the operation were detected and compared.Result:1.Blood loss,time of aeration and hospitalization time in LPD group were all shorter or lower than those of OPD group(P<0.05),but Operative time in LPD group were longer than those of OPD group(P<0.05).2.There was no statistical difference in detection indexes of serum stress hormones on preoperative 1d between the two groups(P>0.05).each indicators of OPD group were significantly higher than that of the LPD group between perioperation(P<0.05).Each indicators of the two groups rise at first and goes down latter between postoperative.While those indexes at 3 d after operation in LPD group were significantly superior than those of OPD group(P<0.05).3.There was no statistical difference in oxidative stress indexes on preoperative 1 d between the two groups(P >0.05).Indicators of SOD GSH-Px TAC in LPD group go down at first and rise later between perioperation,while the indicator of ROS rises at first and goes down latter between perioperation.Those indexes at 3 d and 5 d after operation in LPD group were significantly superior than those of OPD group(P<0.05).Conclusions:Compared with OPD,LPD has the advantages of less bleeding,shorter hospital stay,quicker recovery of gastrointestinal and less postoperative complications and brings less impact on the systemic stress degree and oxidative stress.In all,LPD is more conductive to the patient's postoperative recovery.