The Effect Of Laparoscopic Colorectal Cancer Specimen Removal Through Natural Cavity On Postoperative Oxidative Stress And Immunology

Objective: To compare traditional laparoscopic assisted incision for radical resection colorectal cancer(LACR)and full laparoscopic colorectal cancer removal through natural cavity specimens(anal)(Laparoscopic colorectal cancer removal through natural cavity specimens,NOSES)The effects of two surgical methods on the oxidative stress response and immune function of the microenvironment in patients after surgery.Methods: A retrospective study of 48 patients diagnosed with colorectal cancer who were hospitalized in the third ward of the Gastrointestinal Surgery Department of the First Affiliated Hospital of Wannan Medical College from September 2018 to December 2020 were the subjects of the study.According to the operation method,they were divided into the observation group(22 cases)and the control group(26 cases).The control groupwas treated with traditional laparoscopic radical resection of colorectal cancer,and the observation group received total laparoscopic surgery to take out specimens through the anus.The pathological stage,perioperative index,oxidative stress index and immunological index of the two groups were analyzed and evaluated.Oxidative stress and immunological indexes were evaluated by detecting the blood superoxide dismutase(SOD),malondialdehyde(MDA),lymphocyte subsets(CD3,CD4,CD8,CD4 / CD8),immunoglobulin(IGA,Ig M,Ig G)and complement system(C3,C4)on the day before operation(D1),the second day after operation(D2)and the seventh day after operation(D3).Results: there was no significant difference in gender,age,pathological T stage,BMI,length of operation,estimated intraoperative total blood loss and number of lymph node dissection between the two groups(P > 0.05).Comparison between the two groups of patients: The SOD,CD3,CD4,CD4/CD8,Ig M,Ig G,and C3 on D2 were significantly lower than those on D1.On D3,the two groups of CD4/CD8,Ig M,Ig G,C3,and SOD were all more effective than D2.Increased(P<0.05),CD3 and CD4 of the control group were higher than D2(P<0.05),MDA of the two groups of patients on D2 were higher than D1(P<0.05),both decreased on D3,and the control group had low MDA on D3 On D2(P<0.05).Comparison between the two groups of patients: On D1,there was no significant difference in serum MDA,SOD,CD3,CD4,CD8,CD4/CD8,Ig A,Ig M,Ig G,C3,C4 values(P >0.05);On D2,the CD3,CD4,CD4/CD8,Ig M,Ig G,Ig A,SOD values of the observation group were higher than those of the control group(P<0.05),and the MDA value of the observation group was lower than the control group(P<0.05);On D3,the CD3,CD4,C3,C4,Ig M,Ig A values of the observation group were not significantly different from those of the control group(P>0.05),and the CD4/CD8,Ig G,SOD values of the observation group were higher than those of the control group(P<0.05),the MDA value of the observation group was lower than that of the control group(P<0.05).Conclusion:Compared with traditional laparoscopic radical resection of colorectal cancer,(Laparoscopic colorectal cancer removal of surgical specimens through the natural cavity(anus))laparoscopic radical resection of colorectal cancer through natural cavity(anus)can significantly reduce the postoperative oxidative stress reaction and the impact on the immune system of patients,reduce the related factors that may cause surgical complications,and contribute to the recovery of patients.