Objective To explore the change of carcinomacmbryonic-antigen (CEA) and dopa decarboxylase (DDC) in the peritoneal irrigation fluid from patients undergoing Da Vinic robotic,laparoscopic and open radical gastrectomy for gastric cancer.Methods The clinical data of 126 patients undergoing radical gastrectomy for gastric cancer at the Southwest Hospital from January 2013 to March 2014 were retrospectively analyzed.There were 42 patients in the Da Vinic robotic radical gastrectomy group (RRG group),42 in the laparoscopic radical gastrectomy group (LRG group) and 42 in the open radical gastrectomy group (ORG group).The preoperative and postoperative peritoneal irrigation fluids were collected,respectively.Concentrations of CEA and DDC in the peritoneal irrigation fluids were detected by the enzyme-linked immunosorbent assay (ELISA).The quantitative data were analyzed using the t test and the chi-squared test,the multiple comparison were analyzed using the least significance difference (LSD) and the count data were analyzed using the chi-square test and nonparametric test.Results The preoperative and postoperative concentrations of CEA in the RRG group,LRG group and ORG group were (242 ± 189)xg/L,(221 ± 174)μg/L,(257 ± 135) μg/L and (1 262 ± 785) μg/L,(1 172 ± 699) iμg/L,(2 996 ± 1 947) μg/L,respectively.The preoperative and postoperative concentration of DDC in the RRG group,LRG group and ORG group were (8 ±5)μg/L,(7 ±4)μg/L,(8 ±6)μg/L and (87 ±55) μg/L,(81 ±52) pg/L,(146 ± 135)μg/L,respectively.No significant differences were observed for the preoperative concentrations of CEA and DDC in the 3 groups (F =0.491,0.161,P ＞ 0.05),and the postoperative concentration of CEA and DDC in the 3 groups were significantly different (F =27.214,6.865,P ＜ 0.05).The postoperative concentration of CEA and DDC in the ORG group were significantly higher than those in the RRG group and LRG group (P ＜ 0.05),while no significant differences in the postoperative concentration of CEA and DDC were observed between the LRG group and RRG group (P ＞ 0.05).The preoperative and postoperative concentrations of CEA and DDC were significantly increased in all the 3 groups,with a significant difference when compared with the preoperative concentrations of CEA and DDC (t =-11.053,-11.700,-9.780,-10.261,-9.955,-6.969,P ＜0.05).Conclusion The postoperative concentration of CEA and DDC in the peritoneal irrigation fluid after Da Vinic robotic radical gastrectomy is significant decreased when compared with the open radical gastrectomy,while no significant difference is observed between the Da Vinci robotic radical gastrectomy and the laparoscopic radical gastrectomy,which is helpful for preventing CEA-and DDC-mediated abdominal metastasis of gastric cancer.
Key words:
Gastric neoplasms; Da Vinic robotic surgery system; Laparoscopy; Carcino-embryonic antigen ; Dopa decarboxylase