Comparative Evaluation Of Surgical Stress Of Laparoscopic And Open Surgeries For Colorectal Carcinoma

Purpose : To objectively evaluate the benefits of laparoscopic procedures for colorectal carcinoma, a prospective study to measure the stress response to laparoscopic surgery (n=20) compared with open surgery (n=20) was undertaken. Methods: Peripheral blood samples were obtained to measure peripheral leukocytes, lymphocytes counts, neutrophil granulocyte rate, serum C-reactive protein , interleukin-6, interleukin-8, tumor necrosis factor-α, soluble intercellular adhesion molecules, CD11b expression on peripheral leukocytes at six hours before and six hours after surgery and on Days 1, 3, 5 after surgery . Additionally, operation time, bleed amount in operation, body temperature before and after surgery,duration of fever,recovery time of bowel function, postoperative hospital stay and complications .Results: The peripheral leukocytes counts , neutrophil granulocyte rate, serum C-reactive protein interleukin-6, interleukin-8, tumor necrosis factor-α, soluble intercellular adhesion molecules levels were significantly higher in the laparoscopy and open groups after surgery (P<0.05), respectively. But in the laparoscopy group, the levels of these parameters above were significantly lower than in the open group and had a rapid recovery after surgery (P<0.05). Lymphocyte counts and CD11b expression on peripheral leukocytes were significantly lower in both groups after surgery (P<0.05). CD11b expression on polymorphonuclear leukocytes was significantly lower after the laparoscopic approach , while CD11b expression on lymphocytes was higher in the laparoscopy group. There was no differences in their lymphocytes counts in both groups after surgery. Operating time was longer for the laparoscopy group, but it has less operation bleeding , quicker recovery of bowel movement , shorter hospital stay, lower body temperature and shorter fever period after operation. Conclusions: By monitoring these parameters , our study demonstrated that laparoscopic surgery for colorectal carcinoma leads to less postoperative stress and caused less effects on immune function than conventional open surgery, which would be advantageous for a rapid recovery.