| BackgroundSince the early1990s,when the American Surgeons Jacobs successfully completed the world’s first laparoscopic colon cancer redical resection, because of less trauma, less pain, rapider recovery, shorter hospital stay, less postoperative complications and other benefits, minimally invasive surgery(MIS)has quickly carried out world-wide.Especially in the past10years, with the laparoscopic surgical instruments such as harmonic ultrasound scalpel, argon scalpel, endoscopic stapler(Endo-GIA),absorbable clips,endoscopic hemostatic materials and so on continuous improving, also continuous improvement in laparoscopic surgical skills,laparoscopic surgery in the treatment of digestive system tumors has become the preferred surgical approach of the majority of doctors and patients following laparoscopic cholecystectomy (Laparoscopic cholecystectomy, LC). However, in order to build the necessary surgery space,we usually use carbon dioxide to generate pneumoperitoneum.Thus,the impact of carbon dioxide pneumoperitoneum on digestive system cancer gradually attracts researchers’ attention.Among the controversy, one of the focus is that whether carbon dioxide pneumoperitoneum will cause the malignant tumors proliferation or metastasis.At present, most researches of the world are focusing on the impact of carbon dioxide pneumoperitoneum on blood coagulation, immune,puncture transfer et al.While the effect of carbon dioxide pneumoperitoneum on peripheral blood urokinase-type plasminogen activator (uPa) and the relationship between uPa colorectal tumor hematogenous transfer is rarely reported.ObjectiveCollect information of patients undergone either laparoscopic colorectal cancer radical resection(LCCRR) or open colorectal cancer radical resection(OCCRR), compare the contents change of uPa in their peripheral blood to discuss laparoscopic surgery(LS) and traditional open surgery (OS), the impact of the two surgical procedures on peripheral blood uPa with digestive system malignant tumors.MethodsTo collect a total of91cases of colorectal cancer patients in the Henan Provincial People’s Hospital from July2010to December2011,these patients were divided into two groups.The laparoscopic colorectal cancer radical resection (LCCRR) group included50cases while the open colorectal cancer radical resection (OCCRR) group included41cases.Collect all the clinical datas to analysis. Each patient was taken blood of3ml from peripheral blood one day before operation and4weeks after surgery. The content of uPA in the samples of the two groups was detected by ELISA. The detection reagent is human uPa quantitative ELISA kits, while the detection is according the instructions strictly. The test data obtained were analyzed under requirements of Statistics. Then Compared changes of the uPa content preoperative and postoperative in peripheral blood of the two groups in order to discuss the relationship between uPa in peripheral and different pathological stage, also the effect of carbon dioxide pneumoperitoneum on uPa of patients with colorectal cancer.ResultsThe operation time of the LS group and OS group were (3.5±1)h and(3.0± 0.75) h.There is a statistically significant difference between the two groups (P=0.014<0.05). The time of the OS group is shorter. The uPa content in peripheral blood one day before the operation of the LS group and OS group were1.43±0.47ng/ml and1.47±0.50ng/ml. Between the two groups, there is no significant statistically difference (P=0.768>0.05).After the operation, the uPa content of the two groups were1.03±0.16ng/ml and0.99±0.22ng/ml. Compared the two groups, the difference was not statistically significant (P=0.395>0.05). Before the operation, the uPa content in peripheral blood of Dukes A+B (early cancer) was1.12±0.29ng/ml, while the content of Dukes C is1.85±0.37ng/ml. After the operation, the uPa content of the two group were0.94±0.18ng/ml and1.10±0.16ng/ml. Compared the two groups, the differences were both statistically significant (P<0.01)regardless of preoperative and postoperative. Before the surgery, well-differentiated adenocarcinoma and poorly differentiated adenocarcinoma of peripheral blood uPa content were0.96±0.23ng/ml and1.64±0.42ng/ml, the difference was statistically significant (P=<0.01).After the surgery, the uPA content in the two groups in peripheral blood were1.02±0.19ng/ml and1.12±0.19ng/ml. The two groups compared, the difference was statistically significant (P=<0.01).Conclusion1.The content of uPa in the peripheral blood of patients with colorectal cancer is related to the clinical pathology of malignant tumor stages, lymph node metastasis and tumor differentiation which can enhance the invasiveness of malignant tumors.2.Compared to Open Colorectal Cancer Radical Resection, Laparoscopic Colorectal Cancer Radical does not increase the uPA level in peripheral blood of patients with colorectal cancer. |
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