Emergency exploratory laparotomy and radical gastrectomy in patients with gastric cancer combined with acute upper gastrointestinal bleeding

Table 1 Comparison of general data in each group

Items	Category	Radical resection group (n = 46)	Palliative group (n = 43)	t/χ2	P value
Age (yr)		69.7 ± 10.2	70.3 ± 10.5	0.273	0.785
Gender	Male	26	25	0.952	0.877
	Female	20	18
Pathological type	Adenocarcinoma	18	16	0.719	0.869
	Mucus adenocarcinoma	14	12
	Signet ring cell carcinoma	11	10
	Non-adenocarcinoma	3	5
Tumor location	Whole stomach	9	8	0.186	0.979
	Lower	18	16
	Middle	12	11
	Upper	7	8

Table 2 Comparison of the patients’ relevant indicators between the two groups (mean ± SD)

Group	Palliative group (n = 43)	Radical resection group (n = 46)	t	P value
Operation time (min)	275.32 ± 29.45	281.34 ± 22.67	1.085	0.281
Intraoperative blood transfusion volume (mL)	356.45 ± 54.87	286.0 ± 42.43	6.801	< 0.001
Postoperative hospitalization duration time (d)	14.54 ± 3.37	13.43 ± 3.22	1.589	0.116
Anal exhaust time (d)	6.54 ± 1.43	4.62 ± 1.35	6.516	< 0.001
Off-bed activity time (d)	9.36 ± 1.38	6.87 ± 1.23	8.998	< 0.001

Table 3 Comparison of the patients’ incidence rate of postoperative complications between the two groups, n (%)

Group	Palliative group (n = 43)	Radical resection group (n = 46)	χ2	P value
Postoperative bleeding	2 (4.65)	3 (6.52)	-	-
Duodenal stump rupture	2 (4.65)	2 (4.35)	-	-
Anastomotic obstruction	1 (2.32)	3 (6.52)	-	-
Intestinal obstruction	3 (4.35)	2 (4.35)	-	-
Abdominal effusion	2 (4.65)	1 (2.17)	-	-
Reflux gastritis	2 (4.65)	3 (6.52)	-	-
Incision infection	1 (2.32)	3 (6.52)	-	-
Overall incidence rate	12 (27.91)	17 (39.96)	0.494	0.363

Table 4 Comparison of the patients’ relevant indicators of postoperative immune function between the two groups (mean ± SD)

Index of correlation		Palliative group (n = 43)	Radical resection group (n = 46)	t	P value
CD3+ (%)	Pre-operation	53.72 ± 3.61	52.13 ± 4.21	1.906	0.059
	Post-operation	50.12 ± 2.32	63.52 ± 5.81	14.10	0.043
CD4+ (%)	Pre-operation	31.92 ± 2.83	30.81 ± 3.11	1.857	0.067
	Post-operation	28.32 ± 2.46	40.34 ± 3.01	20.54	0.036
CD8+ (%)	Pre-operation	25.32 ± 2.13	25.34 ± 2.04	1.589	0.085
	Post-operation	27.24 ± 2.05	25.22 ± 2.25	4.417	0.033
CD4+/CD8+	Pre-operation	1.34 ± 0.32	1.32 ± 0.33	0.289	0.773
	Post-operation	1.25 ± 0.34	1.63 ± 0.43	4.603	0.065
CD3+/HLADR+	Pre-operation	7.23 ± 2.53	7.52 ± 2.62	1.572	0.658
	Post-operation	6.35 ± 2.84	8.63 ± 3.14	1.767	0.023
IgG	Pre-operation	11.13 ± 1.58	11.27 ± 1.27	0.548	0.664
	Post-operation	14.68 ± 2.28	18.35 ± 2.16	5.256	0.037
IgM	Pre-operation	3.24 ± 0.32	3.21 ± 0.28	0.363	0.846
	Post-operation	3.56 ± 3.19	3.87 ± 0.53	3.292	0.016

Table 5 Comparison of the patients’ levels of postoperative tumor markers and inflammatory factors between the two groups (mean ± SD)

Index of correlation		Palliative group (n = 43)	Radical resection group (n = 46)	t	P value
CEA (ng/mL)	Pre-operation	38.63 ± 3.48	38.63 ± 3.48	0.413	0.753
	Post-operation	15.36 ± 1.61	7.72 ± 0.72	4.974	0.003
CA199 (U/mL)	Pre-operation	83.63 ± 5.64	82.72 ± 5.82	0.359	0.645
	Post-operation	33.27 ± 4.39	18.57 ± 3.15	3.292	0.012
CA125 (U/mL)	Pre-operation	65.34 ± 4.54	64.43 ± 4.68	0.931	0.354
	Post-operation	40.33 ± 3.24	34.34 ± 3.66	8.153	0.002
IL-6 (pg/mL)	Pre-operation	44.72 ± 7.32	44.76 ± 7.32	0.724	0.463
	Post-operation	36.87 ± 2.77	27.47 ± 2.59	2.472	0.015
IL-17 (pg/mL)	Pre-operation	64.32 ± 5.96	62.46 ± 7.48	0.934	0.723
	Post-operation	54.63 ± 6.27	43.14 ± 5.69	2.772	0.028
TNF-α (pg/mL)	Pre-operation	17.44 ± 2.35	16.57 ± 2.28	0.513	0.674
	Post-operation	9.36 ± 0.87	5.58 ± 0.46	4.562	0.013

CEA: Carcinoembryonic antigen; CA199: Carbohydrate antigen 199; CA125: Carbohydrate antigen 125; IL-6: Interleukin-6 IL-17: Interleukin-17; TNF-α: Tumor necrosis factor α.

Table 6 Comparison of the patient’s postoperative quality of life between the two groups, n (%)

Item		Palliative group (n = 43)	Radical resection group (n = 46)	t	P value
Efficacy	CR	21 (48.84)	35 (76.09)	-	-
	PR	8 (18.60)	8 (17.39)	-	-
	SD	10 (23.26)	3 (6.52)	-	-
	PD	4 (9.30)	0 (0.00)	-	-
	ORR	29 (67.44)	43 (93.48)	0.004	0.044
	DCR	39 (90.69)	46 (100.00)	0.109	0.034
KPS score	Improved	23 (50.00)	10 (23.26)	0.017	0.009
	Stable	14 (30.43)	15 (34.88)	0.825	0.655
	Ineffective	9 (19.57)	18 (41.86)	0.039	0.022
	Effective	37 (80.43)	25 (58.14)	0.039	0.022

CR: Complete response; PR: Partial response; SD: Stable disease; PD: Progressive disease; ORR: Objective response rate; DCR: Disease control rate.

Table 7 Comparison of the patient’s postoperative survival rate between the two groups, n (%)

Item		Palliative group (n = 43)	Radical resection group (n = 46)	t	P value
Follow-up 6 mo	Recurrence rate	5 (11.63)	3 (6.52)	0.400	0.638
	Survival rate	39 (90.71)	46 (100.00)	0.109	0.034
Follow-up 1 year	Recurrence rate	6 (13.95)	1 (2.17)	0.095	0.039
	Survival rate	34 (79.07)	45 (97.83)	0.0134	0.005
Follow-up 2 year	Recurrence rate	9 (20.93)	1 (2.17)	0.013	0.005
	Survival rate	27 (62.79)	40 (86.96)	0.017	0.008