不同淋巴结清扫范围的胃癌根治手术对机体的侵袭

摘要

Objective: To evaluate the effects of surgical trauma of open surgery on the patients with gastric carcinoma who underwent different lymph node dissection. Methods: Total 30 patients with gastric carcinoma were divided into three groups (D1, D2, and D3) according to the extent of lymph node dissection. Peripheral blood samples were taken to measure the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), C-reactive protein (CRP) and polymorphonuclear elastase (PMNE). Additionally, leucocytes and lymphocytes counts in peripheral serum were also detected. Results:All the three groups showed a significant increase of the levels of IL-6, IL-8, CRP and PMNE after operation. There was no significant difference between D1 and D2 groups. When the comparison was made between D3 group and the other two groups, it showed higher concentration of IL-6, IL-8, CRP and PMNE in serum of D3 group. Leucocytes count showed no difference among the three groups. After operation, the patients in three groups had transient lymphocytes decrease on the second and third postoperative days, the lymphocyt es count in D3 group was still lower while those in D1 and D2 groups began to increase. Conclusion: IL-6, IL-8,CRP and PMNE can be used to monitor surgical stress. Using these parameters, we found that extended lymph node dissection of D3 group led to more postoperative stress than D1 and D2 groups.