3D 腹腔镜胃癌根治术治疗进展期胃癌患者的疗效 及对血清外泌体Dicer 和PTEN 的影响.

To investigate the efficacy of 3D laparoscopic radical gastrectomy for advanced gastric cancer and its effect on serum exosome Dicer and Phosphatase and tensin homolog deleted on chromosome ten (PTEN). A total of 60 patients with advanced gastric cancer treated in our hospital from July 2018 to May 2021 were selected as the research subjects. According to 1:1 random envelope lottery, the patients were divided into 3D group and laparotomy group, with 30 patients in each group. The open group was treated with open surgery, and the 3D group was treated with 3D laparoscopic radical gastrectomy. The surgical indications, complications, visual analog scales (VAS) score and Dicer and PTEN expressions of the two groups were compared and analyzed. There were no difference in the operation time and the number of lymph node dissections compared between the two groups(P>0.05). The postoperative exhaust time, postoperative gastric tube removal time, surgical incision length, the amount of bleeding, postoperative hospital stay, and surgery in the 3D group were less than that of the open group (P<0.05). The incidence of complications such as anastomotic bleeding, anastomotic leakage, gastroparesis, incision infection, and venous thrombosis in the 3D group at 14 days after operation were lower than the open group (P<0.05). The VAS scores of the 3D group at 1 d, 7 d and 14 d after operation were lower than those of the open group (P<0.05). The relative expression levels of serum exosomes Dicer and PTEN at 14 d after operation in the two groups were higher than that at 1d before operation (P<0.05), the 3D group were higher than the open group (P<0.05). All patients were followed up until November 1, 2021. The average follow-up time were (17.92± 0.22) months. The recurrence rate of the 3D group were 3.33 %, which were lower than the 20.00 % of the open group (P<0.05). 3D laparoscopic radical gastrectomy for patients with advanced gastric cancer can promote the secretion of serum exosome Dicer and PTEN without increasing the complexity of surgery, and can also promote the recovery of patients, reduce complications, relieve patients' pain, and reduce the recurrence rate during follow-up. [ABSTRACT FROM AUTHOR]