Abstract:
Objective To investigate the effect of Da Vinci robot radical gastrectomy on gastrointestinal motility and hormones of gastric cancer patients.
Methods We selected 217 patients who underwent radical gastrectomy. According to different surgical methods, the patients were divided into Da Vinci operation group and open operation group.The recovery time of bowel sounds and the time of first anal exhaust after operation were recorded. The levels of gastrointestinal hormones, surgical-related factors and inflammatory factors were measured before and after operation.
Results The recovery time of bowel sounds and the first time of anal exhaust in the Da Vinci operation group were shorter than those in the open operation group(both P < 0.05). The motilin, gastrin, somatostatin levels at 24h after operation were significantly lower than those at 12h before operation in both groups(all P < 0.05), the vasoactive intestinal peptide levels were significantly increased(P < 0.05). At 24h after operation, the motilin and gastrin levels in the Da Vinci operation group were higher than those in the open operation group(both P < 0.05); the levels of vasoactive intestinal peptide in the Da Vinci operation group were lower than those in the open operation group(P < 0.05). In all patients, the recovery time of bowel sounds and the time of first anal exhaust were negatively correlated with the motilin and gastrin levels(P < 0.05), while they were positively correlated with the levels of vasoactive intestinal peptide at 24h after operation(all P < 0.05). There were significant differences in operative time, operative blood loss, drainage tube removal time, VAS pain grade and inflammatory factors between the two groups(all P < 0.05).
Conclusion The recovery of gastrointestinal motility of gastric cancer patients treated with Da Vinci surgery is significantly faster than that with traditional laparotomy. The inflammation and stress reaction caused by trauma may be the important factors affecting gastrointestinal hormone secretion.