Effect of laparoscopic-assisted D2 radical resection for distal gastric cancer on the level of tumor related factors

Abstract:

Objective To explore the effect of laparoscopic-assisted D2 radical resection for advanced distal gastric cancer on serum pepsinogen（PG），gastrin-17（G-17），hypoxia-inducible factor-1α（HIF-1α），and metastasis-associated in colon cancer-1（MACC1） levels.Methods A total of 110 patients who underwent D2 radical resection for distal gastric cancer in General Hospital of Central Theater Command from October 2017 to November 2021 were selected for clinical and follow-up study. According to the different treatment methods，they were divided into the laparoscopic group and the laparotomy group，with 55 cases in each. Perioperative conditions，serum PG，G-17，HIF-1α and MACC1 levels，and differences in survival between the two groups of patients were compared.Results The length of incision，intraoperative blood loss，exhaust time，eating time，time to first get out of bed， and hospital stay in the laparoscopic group were significantly lower than those in the laparotomy group，and the differences were statistically significant（P<0.05）. On the 7th day after operation， the serum PGⅠ level in the laparoscopy group was significantly higher than that in the laparotomy group（P<0.05），and the levels of G-17，HIF-1α and MACC1 were lower than those in the laparotomy group（P<0.05）. In the early postoperative period，the overall incidence of complications in the laparoscopic group was lower than that in the laparotomy group（5.45% vs. 20.00%）（P<0.05）. The 1-，2-，and 3-year survival rates were 90.91%，80.00%，and 78.18% in the laparoscopic group，and 87.27%，74.55%，and 70.91% in the laparotomy group，and the mortality rate was not statistically significant（P>0.05）. There was no significant difference in survival status between the laparoscopic group and the laparotomy group by log-rank test（P>0.05）.Conclusion Laparoscopy-assisted D2 radical resection for distal gastric cancer has good effect and safety in the treatment of advanced gastric cancer. It can promote early postoperative recovery of patients，and improve patients' PG，G-17，HIF-1α and MACC1 levels.