title: Comparison of short-term outcomes and perioperative systemic immunity of laparoscopy-assisted and open radical gastrectomy for gastric cancer.
abstract: OBJECTIVE
  To compare the perioperative systemic immunity of laparoscopy-assisted and open radical gastrectomy for gastric cancer.
  
  
  METHODS
  Patients with gastric adenocarcinoma proven by endoscopy and biopsy were eligible, while patients with preoperative staging of T4, N2-3, or M1 were excluded. Eligible patients willing to undertake laparoscopic surgery in the consecutive cohort were assigned to the laparoscopy-assisted gastrectomy (LAG) group, while concurrent patients were assigned to the conventional open gastrectomy (OG) group. All operations were performed with the intention of radical resection. Various immunological parameters were tested in peripheral venous blood collected at preoperative 1(st) day and postoperative 2(nd) day (POD2) and 7(th) day (POD7). SPSS 13.0 software was used for statistical analysis.
  
  
  RESULTS
  Thirty patients were included, 15 each in the LAG and OG groups. The general characteristics and short-term outcomes (harvested lymph nodes number, hospital stay, complications, and mortality rate) of the two groups were comparable, but the operation time was significantly longer in LAG (P = 0.001). Moreover, intergroup comparisons indicated no significant differences between the groups in levels of neutrophils, T-lymphocytes, natural killer cells, IgG, IgM, IgA, C3, C4, interleukin-6, or interleukin-10 at any time point (P>0.05). However, there was a gradual decrease in natural killer cell count in the LAG group up to POD7 (P = 0.008).
  
  
  CONCLUSIONS
  The changes in systemic immunity markers were comparable between laparoscopy-assisted and open gastrectomy for gastric cancer. However, there was a trend of suppression of natural killer cells in the laparoscopy-assisted gastrectomy group.
authors.affiliation: Department of Gastrointestinal Surgery and Multi-disciplinary Team of Gastrointestinal Tumors, West China Hospital, Sichuan University, China.
authors.forename: Xin-Zu
authors.initials: XZ
authors.lastname: Chen
authors.forename: Jian-Kun
authors.initials: JK
authors.lastname: Hu
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
authors.forename: Kun
authors.initials: K
authors.lastname: Yang
authors.forename: Zong-Guang
authors.initials: ZG
authors.lastname: Zhou
authors.forename: Lan-Lan
authors.initials: LL
authors.lastname: Wang
authors.forename: Chen
authors.initials: C
authors.lastname: Yang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Chen
authors.forename: Jia-Ping
authors.initials: JP
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007109:Immunity; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome