Effect of double-tract reconstruction and laparoscopic proximal gastrectomy on immune function and stress

Table 1 General information of two groups

Indicators	Research group (n = 39)	Control group (n = 39)	t/χ2	P value
Age (years)	58.31 ± 7.30	55.69 ± 6.52	1.672	0.099
Sex (male/female)	12/27	18/21	1.950	0.163
Tumor diameter (cm)	2.33 ± 0.99	1.95 ± 0.68	1.976	0.052
Lymphatic vessel infiltration (positive/negative)	8/31	9/30	0.075	0.784
Differentiation degree (high differentiation/moderate-low differentiation)	6/33	5/34	0.106	0.745
Preoperative imaging staging (stage I/stage II)	5/34	4/35	0.126	0.723

Table 2 Perioperative indices of two groups

Indicators	Research group (n = 39)	Control group (n = 39)	t	P value
Intraoperative blood loss (mL)	219.03 ± 53.68	245.08 ± 38.65	2.459	0.016
Digestive tract anastomosis time (minutes)	30.08 ± 5.64	33.51 ± 9.44	1.948	0.055
Time to first postoperative anal exhaust (days)	2.44 ± 0.85	3.10 ± 0.79	3.552	< 0.001

Table 3 Postoperative complications of two groups, n (%)

Indicators	Research group (n = 39)	Control group (n = 39)	χ2	P value
Intestinal obstruction	0 (0.00)	0 (0.00)
Anastomotic ulcer	0 (0.00)	0 (0.00)
Diarrhea	1 (2.56)	1 (2.56)
Dumping syndrome	0 (0.00)	4 (10.26)
Gastroesophageal reflux	1 (2.56)	3 (7.69)
Total	2 (5.13)	8 (20.51)	4.129	0.042

Table 4 Nutritional parameters of two groups

Indicators	Research group (n = 39)	Control group (n = 39)	t	P value
Alb (g/L)
Before surgery	36.51 ± 4.23	35.49 ± 3.20	1.201	0.234
1 month after surgery	38.72 ± 3.68a	38.74 ± 2.41a	0.028	0.977
2 months after surgery	41.15 ± 2.95b	38.72 ± 2.99b	3.613	< 0.001
3 months after surgery	42.79 ± 3.18b	40.08 ± 3.14b	3.787	< 0.001
Hb (g/L)
Before surgery	129.08 ± 13.70	127.18 ± 13.31	0.621	0.536
1 month after surgery	131.56 ± 12.94	131.36 ± 13.13	0.068	0.946
2 months after surgery	134.21 ± 11.08	128.95 ± 7.39	2.466	0.016
3 months after surgery	135.87 ± 11.16a	130.41 ± 9.57	2.319	0.023
BMI (kg/m2)
Before surgery	21.69 ± 2.03	21.72 ± 1.70	0.071	0.944
1 month after surgery	21.72 ± 2.01	21.46 ± 1.96	0.578	0.565
2 months after surgery	22.62 ± 2.60	21.23 ± 1.46	2.911	0.005
3 months after surgery	23.05 ± 2.69a	20.15 ± 1.91b	5.489	< 0.001

^aP < 0.05, compared with before surgery.

^bP < 0.01, compared with before surgery.

Alb: Albumin; Hb: Hemoglobin; BMI: Body mass index.

Table 5 Immune function of two groups

Indicators	Research group (n = 39)	Control group (n = 39)	t	P value
IgG (g/L)
Before surgery	12.23 ± 1.72	11.97 ± 2.03	0.610	0.544
1 day after surgery	9.90 ± 1.68b	8.05 ± 2.28b	4.079	< 0.001
IgA (g/L)
Before surgery	3.12 ± 1.01	3.26 ± 1.10	0.585	0.560
1 day after surgery	1.87 ± 0.90b	1.38 ± 0.49b	2.986	0.004
IgM (g/L)
Before surgery	0.87 ± 0.30	0.97 ± 0.27	1.547	0.126
1 day after surgery	0.65 ± 0.25b	0.42 ± 0.17b	4.751	< 0.001

^bP < 0.01, compared with before surgery.

IgG: Immunoglobulin G; IgA: Immunoglobulin A; IgM: Immunoglobulin M.

Table 6 Stress response of two groups

Indicators	Research group (n = 39)	Control group (n = 39)	t	P value
CRP (ng/mL)
Before surgery	3.05 ± 0.69	2.95 ± 0.65	0.659	0.512
1 day after surgery	86.64 ± 10.66c	103.67 ± 12.71c	6.411	< 0.001
3 days after surgery	64.36 ± 5.86b	87.33 ± 8.58b	13.806	< 0.001
5 days after surgery	21.77 ± 2.92b	38.92 ± 3.72b	22.647	< 0.001
IL-6 (pg/mL)
Before surgery	78.33 ± 6.69	81.05 ± 6.39	1.836	0.070
1 day after surgery	310.77 ± 38.79c	398.13 ± 45.78c	9.092	< 0.001
3 days after surgery	238.00 ± 18.60c	332.64 ± 45.73c	11.972	< 0.001
5 days after surgery	106.97 ± 12.24b	201.36 ± 17.14b	27.988	< 0.001
TNF-α (ng/mL)
Before surgery	43.08 ± 7.19	45.44 ± 5.70	1.606	0.112
1 day after surgery	134.85 ± 20.56c	163.03 ± 22.68c	5.749	< 0.001
3 days after surgery	107.92 ± 11.51b	153.54 ± 20.08b	12.309	< 0.001
5 days after surgery	66.72 ± 10.45b	83.74 ± 10.45b	7.192	< 0.001

^bP < 0.01, compared with before surgery.

^cP < 0.001, compared with before surgery.

CRP: C-reactive protein; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α.