title: [Effect of minimally invasive Ivor-Lewis esophagectomy on acute phase responses in patients with esophageal carcinoma].
abstract: OBJECTIVE
  To explore the effect of minimally invasive Ivor-Lewis esophagectomy on acute phase responses in patients with esophageal carcinoma.
  
  
  METHODS
  Forty-eight patients with middle or low thoracic esophageal carcinoma underwent Ivor-Lewis esophagectomy. The patients were divided into small incision group (n = 25) and conventional group (n = 23) according to the patients' will. Serum levels of acute phase proteins C reactive protein (CRP), haptoglobin (HPT), α₁-acid glycoprotein (α₁-AG), ceruloplasmin (CER), transferrin (TRF), β₂-microglobulin (β₂-MG), album protein (ALB), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) were measured and compared on 1st day before operation, at 18 hours as well as 3rd and 7th day after operation.
  
  
  RESULTS
  There was no significant difference in all the acute phase proteins indicators and IL-6 between the small incision and conventional groups at each time points after operation (P > 0.05). In both groups the levels of CRP, α₁-AG and HPT were significantly higher after operation than before operation (P < 0.05). The levels of ALB and TRF were significantly lower after operation than before operation (P < 0.05). The levels of CER and β₂-MG were not significantly different during perioperative period (P > 0.05). The level of TNF-α was significantly higher in the small incision group than that in the conventional group at the 18 hours postoperationally (P < 0.05), and were not significantly different on the other time points between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Compared with conventional operation, the small incision Ivor-Lewis esophagectomy do not significantly alleviate the stress of the surgical trauma in patients. Unchanging the essence of operation, if one is trying to minimize the stress caused by surgery on patients, the key factor is not the size of incision. An effective approach should be found in other operation-related factors.
authors.affiliation: Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu 610041, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fang
authors.forename: Yong-tao
authors.initials: YT
authors.lastname: Han
authors.forename: Guang-guo
authors.initials: GG
authors.lastname: Ren
authors.forename: Chang-ning
authors.initials: CN
authors.lastname: Ye
authors.forename: Tai-chang
authors.initials: TC
authors.lastname: Tan
authors.forename: Lin
authors.initials: L
authors.lastname: Peng
authors.forename: Bo
authors.initials: B
authors.lastname: Xiao
authors.forename: Wen-guang
authors.initials: WG
authors.lastname: Xiao
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism*; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000601:surgery; D002570:Ceruloplasmin / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000097:blood* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009961:Orosomucoid / Q000378:metabolism; D059035:Perioperative Period; D012709:Serum Albumin / Q000378:metabolism; D000075462:Serum Albumin, Human; D014168:Transferrin / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: C422455:ALB protein, human; D000209:Acute-Phase Proteins; D006242:Haptoglobins; C508600:IL6 protein, human; D015850:Interleukin-6; D009961:Orosomucoid; D012709:Serum Albumin; D014168:Transferrin; D014409:Tumor Necrosis Factor-alpha; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D002570:Ceruloplasmin; D000075462:Serum Albumin, Human