Laparoscopic Versus Open Resection For Colorectal Cancer: A Comparison On The Postoperative Insulin Resistance

BackgroundThe laparoscopic technique had been used in the treatment of colorectal cancer nearly 20 years. Update because of laparoscopic equipment, advanced surgical instruments and surgical techniques improve, so that laparoscopic radical resection of colorectal cancer is technically possible, operation and accuracy of vision or even better than laparotomy. At the same time,at home and abroad have been reported in related literature that laparoscopic radical resection of colorectal cancer than the traditional laparotomy with incision pain, faster postoperative recovery, the advantages of shorter hospitalization time. However, laparoscopic colorectal resection and traditional open surgery in the organization of trauma and whether glucose metabolism is different, both at home and abroad reported the lack of relevant research.Objective1. Comparison of laparoscopic colorectal resection and traditional open surgery after the degree of insulin resistance to determine the laparoscopic resection of colorectal tissue trauma even smaller.2. Comparison of laparoscopic colorectal resection and traditional open surgery in patients with early recovery to determine laparoscopic colorectal resection in patients with more conducive to early rehabilitation.Methods60 cases selected into the group in line with the conditions of patients with colorectal cancer, 30 cases of laparoscopic colorectal into the resection group (hereinafter referred to as LCR group), 30 cases of colorectal into the open surgery group (hereinafter referred to as OCR group): 1. observing two groups of patients with inter-group preoperative and postoperative insulin resistance index, insulin secretion index and insulin sensitivity index difference; 2. the two groups were observed in patients with early recovery, including the first postoperative anal exhaust time, the first events to get out of bed the first time, after three days of white blood cells, 3 days after surgery the highest body temperature, body temperature returned to normal time, the incidence of postoperative complications, hospitalization days and so on.Results1. There was no significant differencein gender, age, pathological stage, body mass index, POSSUM score, etc between the two groups of patients(P>0.05).2. Comparison of two groups of patients with group: preoperative and postoperative insulin resistance index were significantly differences (P<0.01),Insulin secretion index was no significant difference(P>0.05),Insulin sensitivity index were significantly differences(P<0.01).3. Comparison between two groups of patients:LCR group and OCR group preoperative insulin resistance index, insulin secretion index, insulin sensitivity index was no significant difference(P>0.05),Postoperative insulin secretion index was no significant difference(P>0.05),Insulin resistance index, insulin sensitivity index were significantly different(P<0.01).4. Two groups of patients at postoperative anal exhaust time, after time out of bed and in-patient days on there is significant difference(P<0.05),At 3 days after the white blood cells, 3 days after surgery the highest body temperature, body temperature returned to normal time no significant difference(P>0.05).Conclusion1. Group comparison: LCR group and OCR groups of insulin secretion index after surgery no significant difference, and higher insulin resistance index, insulin sensitivity index were lower, suggesting that insulin resistance associated with the surgical trauma.2. Inter-group comparison: LCR group and OCR postoperative insulin secretion index preoperatively was no significant difference, and postoperative insulin resistance index OCR group than in LCR group increased markedly, insulin sensitivity index were significantly reduced, suggesting that LCR group tissue trauma group than OCR.3. LCR group at postoperative anal exhaust time, after time out of bed and postoperative hospital stay were less than the number of days on OCR group, suggesting that laparoscopic colorectal resection in patients with more conducive to early recovery.InnovationBy the literature search, in this experiment at home and abroad are about laparoscopic colorectal resection insulin resistance in the preliminary exploration (with proof search). In support of laparoscopic colorectal surgery than the traditional laparotomy lighter degree of postoperative insulin resistance, the degree of tissue trauma even smaller and more conducive to patients provided the basis for early recovery.