Effect of autonomic nervous function on postoperative rehabilitation of gastric cancer patients

XU Pengyan; NAN Haiou; CAI Yuling; LI Jiayu; GE Miaomiao; WANG Gang; JIANG Zhiwei

doi:10.3969/j.issn.1674-3806.2025.06.13

Abstract：Objective To analyze the effect of autonomic nervous function on postoperative rehabilitation of gastric cancer patients.Methods The clinical data of 72 patients with gastric cancer who received laparoscopic radical gastrectomy in Department of General Surgery,Affiliated Hospital of Nanjing University of Chinese Medicine(Jiangsu Province Hospital of Chinese Medicine)from November 2022 to May 2024 were retrospectively analyzed.After admission,the standard deviation of normal-to-normal intervals(SDNN)values were detected to evaluate the patients' autonomic nervous function.According to SDNN values on the first day before surgery,the patients were divided into low SDNN group(SDNN＜102 ms,32 patients)and normal SDNN group(SDNN:102-180 ms,40 patients).The postoperative recovery and inflammatory indicators were compared between the two groups.Results The time of first exhaust,the time of first consumption of liquid food,and the time of postoperative removal of drainage tube in the normal SDNN group was earlier than that in the low SDNN group,and the postoperative hospitalization days in the normal SDNN group were less than those in the low SDNN group,with statistically significant differences between the two groups(P＜0.05).The Visual Analogue Scale(VAS)scores on the 2nd day and the 3rd day after surgery were lower than those on the 1st day after surgery in both groups,and the VAS scores on the 3rd day after surgery were lower than those on the 2nd day after surgery in the normal SDNN group,with statistically significant differences(P＜0.05).There were no statistically significant differences in VAS scores between the two groups at different time points(P＞0.05).The levels of white blood cell(WBC),high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)on the 1st day and the 3rd day after surgery were higher than those before surgery in both groups,and the levels of WBC on the 3rd day after surgery were lower than those on the 1st day after surgery in both groups,with statistically significant differences(P＜0.05).The level of WBC on the 3rd day after surgery in the normal SDNN group was significantly lower than that in the low SDNN group(P＜0.05).Conclusion Good autonomic nervous function helps gastric cancer patients resist surgical stress,promotes postoperative gastrointestinal function recovery,and improves postoperative pain and inflammatory state.SDNN is expected to become a preoperative pre-rehabilitation indicator to assess the postoperative rehabilitation status of the patients and guide clinical practice.