Study On The Short-term Endpoints Of Conventional Versus Laparoscopic-assisted Surgery In Patients With Colorectal Cancer

Objective: To study the short-term endpoints of conventional versus laparoscopic- assisted surgery in patients with colorectal cancer and summarizes the advantages and disadvantages of laparoscopic-assisted surgery.Methods: The sigmoid colon cancer and the rectal cancer patients who will accept Dixon surgery were divided into laparoscopic-assisted Dixon surgery group (group 1) and conventional open Dixon surgery group ( group 2) by 1:4 ratio randomly, the rectal cancer patients who will accept Miles surgery were divided into laparoscopic-assisted Miles surgery group (group 3) and conventional open Miles surgery group (group 4) by 1:4 ratio randomly, the ascending colon cancer and the right colic fexure cancer patients who will accept the right-side colon resection were divided into laparoscopic-assisted the right-side colon resection surgery group (group 5) and conventional open the right-side colon resection surgery group ( group 6) by 1:4 ratio randomly. Follow-uped each patients and recorded the operation pattern, operative time, the application of analgesia and painkillers, the postoperative 4 hour, 24 hour and 48 hour VAS score, the first bowel movement time, postoperational flatus time ,getting of bed time, taking liquid diet time, the WBC count at postoperative 5 days, incision length, incision was infected or not, the number of resected lymph nodes, postoperative stay time, drug cost,total cost and cost related to the operation ,then the results between group 1 and group 2, group 3 and group 4 ,group 5 and group 6 were analyzed individually.Results: 30 laparoscopic-assisted Dixon surgery cases,120 conventional open Dixon surgery cases,20 laparoscopic-assisted Miles surgery cases,80 conventional open Miles surgery cases,10 laparoscopic-assisted the right-side colon resection surgery cases and 40 conventional open the right-side colon resection surgery cases were done, all surgeries were succeed, there were no serious complications when patients were discharged from hospital.In group 1 and group 2, the difference of abdominal incision length, operative time, the postoperative 4 hour, 24 hour and 48 hour VAS score , analgesic use, the first bowel movement time,postoperational flatus time,total cost and cost related to the operation were statistically significant. (P < 0.05), the difference of getting of bed time, taking liquid diet time, the WBC count at postoperative 5 days. incision condition, the number of resected lymph nodes, postoperative stay time, Drug cost were no statistically significant. (P > 0.05)。In group 3 and group 4, the difference of abdominal incision length, were statistically significant (P < 0.05), the difference of operative time ,operative time ,the postoperative 4 hour, 24 hour and 48 hour VAS score , analgesic use, first bowel movement time, getting of bed time, taking liquid diet time, the WBC count at postoperative 5 days. incision condition, the number of resected lymph nodes, postoperative stay time, Drug cost, total cost and cost related to the operation were no statistically significant. (P>0.05), but the first bowel movement time and postoperational flatus time of group 3 were earlier and the total cost and cost related to the operation were higher than group 4.In group 5 and group 6, the difference of abdominal incision length the postoperative 4 hour, 24 hour and 48 hour VAS score, analgesic use was statistically significant (P < 0.05), the difference of operative time, first bowel movement time, getting of bed time, taking liquid diet time, the WBC count at postoperative 5 days. Incision condition, the number of resected lymph nodes, postoperative stay time, total cost and cost related to the operation ,Drug cost were no statistically significant. (P > 0.05), but the first bowel movement time and postoperational flatus time of group 5 were earlier and the total cost and cost related to the operation were higher than group 6. Operation time of group 5 was longer than group 6.Conclusions: Laparoscopic-assisted colorectal cancer surgery is safe and feasible. Compared with the traditional open surgery with trauma, postoperative pain and postoperative recovery, laparoscopic-assisted colorectal cancer surgery is clearly in advance,but operation time is relatively longer and operation cost is higher. laparoscopic-assisted Dixon surgery and the right-side colon resection surgery may bring relatively greater benefits then laparoscopic-assisted Miles surgery.