Comparison of clinical efficacy between laparotomy and laparoscopic radical surgery for gastric cancer and their effects on CRP, CEA and insulin resistance.

PURPOSE

This study aimed to compare between the clinical efficacy of laparotomy and laparoscopic radical resection of gastric cancer and their effects on C-reactive protein (CRP), carcinoembryonic antigen (CEA) and insulin resistance.

METHODS

210 patients with gastric cancer admitted to Dongying People's Hospital from September 2013 to July 2015 were included in this study. The patients were divided according to surgery type into the laparotomy group (n = 104) and the laparoscopy group (n = 106). The operative time, intraoperative bleeding, lymph node dissection, postoperative exhaust time and postoperative complications were recorded. Peripheral blood CRP and CEA levels were measured by enzyme-linked immunosorbent assay (ELISA). Fasting blood glucose (FBG), AND fasting insulin (FINS) levels were measured before operation and 1, 3 and 7 days after operation. All patients were followed up by telephone and letters for 5 years. The patients in the two groups were investigated by a quality of life questionnaire.

RESULTS

The intraoperative bleeding and postoperative exhaust time in THE laparoscopy group were significantly lower than those in the traditional laparotomy group, while the operative time and the number of lymph node dissections were higher. The CRP and CEA in the laparoscopy group were significantly lower than in the laparotomy group on the 1ST, 2ND and 3RD day after operation (p<0.05). The FBG, FINS and HOMA-IR in the laparoscopy group were significantly lower than those in the laparotomy group on the 1ST and 3RD day after operation (p<0.05). The scores of quality of life in the laparoscopy group were lower than those in the laparotomy group (p<0.05).

CONCLUSION

In conclusion, laparoscopic radical resection of gastric cancer can reduce the levels of CRP, CEA and insulin resistance, while the degree of inflammation and insulin resistance after laparoscopy is lower than that after laparotomy, which is beneficial to postoperative recovery.