Comparison of clinical efficacy of reduced port versus multiport laparoscopy-assisted D2 radical distal gastrectomy
Objective To compare the clinical efficacy and impact on immune function between reduced aperture laparoscopic and conventional porous laparoscopic D2 radical gastrectomy for gastric cancer.Methods Eighty-two patients who underwent D2 radical surgery for gastric cancer admitted to Nanyang Central Hospital from January 2020 to December 2022 were selected as the research subjects.According to the surgical method,they were divided into a reduced pore group and a porous group,with 41 cases in each group.The reduced pore group underwent D2 radical gastrectomy for gastric cancer using reduced pore laparoscopy,while the porous group underwent D2 radical gastrectomy for gastric cancer using conventional porous laparoscopy.The clinical treatment outcomes of two groups,including intraoperative related indicators(surgical time,surgical bleeding volume,abdominal incision length,number of lymph nodes cleaned),postoperative related indicators(number of analgesics used,exhaust time,hospital stay),and incidence of complications were compared.The immunofunctional indicators(CD4+,CD8+,CD4+/CD8+)were measured and compared by flow cytometry before and after surgery.Results The surgical time and number of lymph nodes cleaned in the reduced orifice group were significantly higher than those in the porous group,but the intraoperative blood loss and abdominal incision length in the reduced orifice group were significantly lower than those in the porous group(P＜0.05).The use of analgesic drugs in the reducing pore group was significantly less than that in the porous group,and the hospitalization time was shorter than that of the porous group,but the exhaust time was longer than that of the porous group(P＜0.05).There was no significant difference in the incidence of complications between the two groups(x2=0.213,P=0.644＞0.05).Before surgery,there was no significant difference in the levels of CD4+,CD8+,and CD4+/CD8+between the two groups(P＞0.05).After surgery,the CD4+,CD8+,and CD4+/CD8+levels in the reduced pore group were significantly higher than those in the porous group(P＜0.05).Conclusions Compared with conventional porous laparoscopic D2 radical gastrectomy for gastric cancer,reduced-orifice laparoscopy has better clinical therapeutic effect and less influence on the immune function of patients.
Reduce holesPorousLaparoscopyD2 radical operation for gastric cancerEffect
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