Low peritoneal and systemic inflammatory response after laparoscopy-assisted gastrectomy compared to open gastrectomy

Area of Science:

• Surgical Oncology
• Immunology
• Gastroenterology

Background:

• Gastric cancer treatment often involves gastrectomy, with both open and minimally invasive approaches.
• Evaluating the inflammatory response is crucial for understanding surgical trauma and patient recovery.
• Laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG) represent different surgical modalities.

Purpose of the Study:

• To objectively compare the peritoneal and systemic immune responses between LADG and ODG in gastric cancer patients.
• To assess the impact of surgical approach on key inflammatory markers post-gastrectomy.

Main Methods:

• A comparative study involving 42 gastric cancer patients: 23 underwent LADG and 19 underwent ODG.
• Measurement of interleukin-6 (IL-6) in peritoneal drain fluid.
• Assessment of serum C-reactive protein (CRP), white blood cell (WBC) counts, and incidence of systemic inflammatory response syndrome (SIRS) postoperatively.

Main Results:

• The ODG group exhibited significantly higher serum CRP levels on postoperative day 1 (p=0.007).
• A significantly higher rate of SIRS was observed in the ODG group compared to the LADG group (p<0.001).
• Peritoneal IL-6 levels on postoperative day 1 were significantly elevated in the ODG group (p<0.01).

Conclusions:

• Laparoscopy-assisted distal gastrectomy (LADG) appears to be a less traumatic surgical option for gastric cancer treatment compared to open distal gastrectomy (ODG).
• LADG is associated with a reduced systemic and local inflammatory response post-surgery.