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《Chinese Journal of Difficult and Complicated Cases》 2017-07
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Effect of spleen preservation on immune function in patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy

WU Qianfu;LI Junhua;LIN Zhenhai;ZHANG Zhidong;WEI Hailong;Department of Cardiothoracic Surgery,Danzhou City People's Hospital of Hainan;  
Objective To investigate the effect of spleen preservation on immune function in patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy.Methods Ninety-eight cases of patients with adenocarcinoma of gastroesophageal junction were selected,who were treated in hospital from October 2012 to October 2014,and they were divided into the observation group(52 cases) and control group(46 cases) according to whether the spleen was retained or not.The patients of observation group were treated with palliative total gastrectomy and spleen retention,while the patients of control group were treated with palliative total gastrectomy and splenectomy.The operation and postoperative follow up of 1 to 24 months of survival and changes of the levels of immunoglobulin(IgA,IgG,IgM) and T lymphocyte subsets(CD3~+,CD4~+,CD8~+) of two groups were compared.Results The operation time,intraoperative blood loss,gastrointestinal function recovery time and fluid diet time of the observation group were significantly lower than those of the control group(P 0.05);The levels of IgA,IgG,IgM,CD3~+,CD4~+ and CD4~+/CD8~+ in the two groups were significantly higher than before on the 10 th postoperative day(P 0.05);There were no significant changes in IgA,IgG,IgM,CD3+,CD4 +,CD*4/CD8 +levels in the observation group at 1 month after operation compared to the 10 th postoperative day(P 0.05),while the levels of IgA,IgG,IgM,CD3~+,CD4~+,CD4~+/CD8~+ recovered to preoperative levels in the control group,the difference was statistically significant(t =3.206,t=6.243,t =3.809,t=3.705,t = 2.707,t =2.342,P 0.05);After follow up of1 to 24 months(median follow up of 16.3months),the one year survival rate was 42.1%in the observation group and39.3%in the control group,there was no significant difference between the two groups(x~2=0.084,P =0.773).Conclusion The patients with adenocarcinoma of gastroesophageal junction undergoing palliative total gastrectomy should retain the spleen,which is beneficial to improve the immune function,and has a certain clinical significance for postoperative prognosis.
【CateGory Index】: R735
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【Citations】
Chinese Journal Full-text Database 4 Hits
1 Liang Han;Department of Gastric Oncology,Cancer Hospital,Tianjin Medical University,National Clinical Research Center for Cancer,Tianjin Key Laboratory of Cancer Prevention and Treatment;;Progress of the diagnosis and treatment for adenocarcinoma of esophagogastric junction[J];中华消化外科杂志;2016-11
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【Co-citations】
Chinese Journal Full-text Database 10 Hits
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