| Objective:Studies have shown that about 25%of patients with colorectal cancer have liver metastases at the same time as the cancer is diagnosed,the most common treatment for patients with liver metastases from colorectal cancer is surgical resection of the primary lesion and liver metastases.In this study,we compared the treatment of colorectal cancer patients with liver metastasis with open resection of colorectal cancer and liver metastasis,to analyze the feasibility,effectiveness and safety of laparoscopic resection for colorectal cancer with liver metastasis.Methods:Through the screening of inclusion and exclusion criteria,82 patients with liver metastases from colorectal cancer admitted to our hospital from January 2018 to December 2020 were included in this study,patients in the open group were treated with open resection of colorectal tumors and liver metastases,while those in the laparoscopic group were treated with simultaneous resection of colorectal tumors and liver metastases,there was no significant difference between the two groups(p>0.05),the clinical parameters,postoperative complications,serum inflammatory factors and peripheral blood T lymphocyte were compared between the two groups.Using the statistical method,the measurement data were expressed by((?)±s),the comparison between groups by t test,the comparison between groups by n and%,the comparison between groups byX~2test,p<0.05,the difference was statistically significant.Results:Compared with the open group,the operative time of laparoscopic group was not statistically significant(p>0.05).The first exhaust time of laparoscopic group was earlier than that of open group,the time of getting out of bed was earlier than that of open group,and the time of pulling out drainage tube was earlier than that of open group The hospitalization period of laparoscopic group was shorter than that of laparotomy group(p<0.05).Compared with the open group,1 case of peritoneal effusion,1 case of abdominal infection and 1 case of Anastomotic Fistula occurred in the laparoscopic group,while 1case of peritoneal effusion,3 cases of abdominal infection,5 cases of incisional infection and 1 case of Anastomotic Fistula occurred in the open group The total incidence of laparoscopy group was lower than that of laparotomy group(X~2=4.5006,p<0.05).The serum levels of IL-10 and IL-6 in thelaparoscopic group were significantly lower than those in the open group at 48h postoperatively(p<0.05).The serum levels of IL-10 and IL-6 in the laparoscopic group were significantly lower than those in the open group at 48 h postoperatively(p<0.05).The serum levels of IL-10 and IL-6 in thelaparoscopicgroup and the open group were significantly lower than those in the open group at 48h postoperatively(p<0.05).The levels of CD3~+,CD4~+and CD4~+/CD8~+were significantly higher in the laparoscopic group than in the open group at 48 hours,while the levels of CD8~+and CD4~+/CD8~+were significantly lower in the laparoscopic group than in the open group at 48hours(p<0.05).The levels of CD3~+,CD4~+and CD4~+/CD8~+were significantly lower in the laparoscopic group and the open group than in the open group at 48 hours,and the levels of CD8+were significantly higher than in the open group at 48 hours(p<0.05).All 82 patients were followed up for 6-24 months,with a median survival of 23months(95%CI:19.871-26.129)in the laparoscopic group and 22 months(95%CI:19.311-24.689)in the laparotomy group.The 1-and 2-year disease-free survival rates and1-and 2-year overall survival rates were 87.80%,41.46%,21.95%and 9.76%in the laparoscopic group,the 1-and 2-year disease-free survival rates and 1-and 2-year overall survival rates were 85.37%,39.02%,24.39%and 12.20%in the laparotomy group,with no significant difference(X2=0.766,0.796,0.733,0.747,P>0.05).Conclusion:Concurrent resection of CRC and CRLM has some selective value for patients with CRLM,although there may be no significant difference in postoperative survival and disease-free survival between the two,but compared with traditional laparotomy,laparoscopy CRLM patients have less trauma,less blood loss,faster recovery of intestinal function,earlier ambulation time,and shorter drainage time,the advantage of short length of stay.Because the technique can effectively avoid direct contact with the outside environment,the incidence of postoperative complications such as ascites, pleural effusion,abdominal infection,incision infection,anastomotic leakage,pulmonary infection and intestinal obstruction was lower,and the postoperative inflammatory reaction was milder,it can promote the recovery of the patients after operation,and it can accelerate the recovery of the patients’immune function. |
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