Abstract:

Influence of enhanced recovery after surgery for radical resection of gastric cancer on immune function：a Meta-analysis        WANG Xiang-an, YU Li-ming, FAN Ji-chang, et al. Department of Gastrointestinal Surgery, the Second Affiliated Hospital, Nanchang University, Nanchang 330006, China
Corresponding author：YANG Gang, E-mail：ygrealtom@sohu.com
Abstract    Objective    To evaluate the influence of enhanced recovery after surgery (ERAS) for radical resection of gastric cancer on immune function. Methods    The major domestic and foreign databases were searched to collect the literatures of randomized controlled trial (RCT) about the the comparison of ERAS and conventional perioperative care in radical resection of gastric cancer published by December, 2014 in both Chinese and English. After screening for inclusion, quality assessment and data extraction, Meta-analysis was conducted by the Review Manager 5.2 software. Results    Sixteen studies involving 1101 patients were selected finally, with 563 patients in ERAS group and 538 patients in control group. Results of Meta-analysis showed that the levels of IL-6 on postoperative day (POD) 1, 3 and TNF- α on POD3 and CRP on POD1, 3, 7 in ERAS group were lower than those in control group significantly (all P<0.05) . Those on the rest of the days showed no significant difference (all P>0.05). The levels of IgA on POD1, 3, 7 and IgG on POD3, 6, 7 in ERAS group were higher than those in control group significantly (all P<0.05). But, the levels of IgM on POD1, 3, 7 showed no significant difference between the two groups (all P>0.05) . Conclusion    ERAS for radical resection of gastric cancer can decrease the inflammatory responses and preserve immune function of bodys compared with conventional perioperative care.

Key words: enhanced recovery after surgery, radical resection of gastric cancer, immune function, Meta-analysis

摘要：

目的    评价加速康复外科（enhanced recovery after surgery，ERAS）应用于胃癌根治术对机体免疫功能的影响。 方法    检索国内外主要数据库等有关运用ERAS对比传统围手术期方法行胃癌根治术对机免疫功能影响的随机对照试验（randomized controlled trial，RCT）中英文文献，检索至2014年12月。按纳入和排除标准筛选文献、文献质量评价和提取数据，采用RevMan5.2软件进行Meta分析。 结果    纳入16篇RCT文献，总计1101例病人，其中ERAS组563例，对照组538例。Meta分析显示，ERAS组IL-6水平在术后第1、3天，TNF- α水平在术后第3天，CRP水平在术后第1、3、7天明显低于对照组（P<0.05），其余组间差异无统计学意义（P>0.05）；ERAS组IgA水平在术后第1、3、7天，IgG水平在术后第3、6、7天明显高于对照组（P<0.05），IgM水平在术后第1、3、7天两组间差异无统计学意义（P>0.05）。结论    与传统围手术期管理相比，ERAS应用于胃癌根治术可以减轻机体术后炎性反应和保护机体免疫功能。

关键词: 加速康复外科, 胃癌根治术, 免疫功能, Meta分析