Effect Of Laparoscopic Surgery On Micrometastasis Of Colorectal Cancer

Objective:To investigate micrometastasis in lymph node and peripheralblood after the colorectal cancer and then the difference of micrometastasis of colorectal cancer between laparoscopic surgery and open colorectal surgery was compared.Methord:Forty colorectal cancer of DUKE stage C data which were proved to be expressing CEA were analyzed by retrospective study.The experimental group data of 18 patients accepted laparoscopic colorectal surgery and the control group data of 22 patients accepted open colorectal surgery.The expression of CEA of lymph node were detected by immunohistochemistry,and the missed diagnosis of lymph node metastasis was recorded and analysed.One hundred and eight colorectal cancer data were studyed at the corresponding time period.The experimental group data of 52 patients accepted laparoscopic colorectal surgery,the control group data of 56 patients accepted open colorectal surgery and the negative control group data of 12 patients was health volunteer.The CK19mRNA expression ratio between preoperotive peripheralblood and postoperative peripheralblood was detected by RT-PCR and the CK19mRNA expression ratio variance of peripheralblood in every groups was accounted,then the influence of the two operation ways in the micrometastasis of colorectal cancer were compared.Result:The result of SP detection in lymph node:146 lymph nodes was obstained(8.11 nodes on average) in patients accepted laparoscopic colorectal surgery, 88 of them was positive in pathology examination(60.27%).8 of negative in pathology examination was positive in CEA expression(rate of missed diagnosis: 13.79%).182 nodes was obstained(8.27 on average) in patients accepted open colorectal surgery,112 nodes was positive in pathology examination(61.42%),19 of negative in pathology examination was positive in CEA expression(rate of missed diagnosis:27.14%).There is no difference in lymph node dissection and phthology examination(P＞0.05),and significant difference in missed diagnosis(P＜0.01) between two groups.The CK19mRNA expression ratio between preoperotive peripheralblood and postoperative peripheralblood:A stage 0.153±0.078,B stage 0.287±0.032,C stage 0.361±0.089,D stage 0.192±0.051 in experimental group;A stage 0.097±0.043,B stage0.287±0.032,C stage 0.361±0.089,D stage 0.192±0.051 in contral group.The staging was done according DUKE'S.There was not difference in A stage and D stage (P＞0.05),but was significant difference in B stage and stage(P＜0.01) between two groups.Conclusion:There is no difference in radical cure and lymph node dissection between laparoscopic surgery and open colorectal surgery.The laparoscopic surgery is an operation way that is worthy of popularizing.In contrast with open colorectal surgery,the micrometastasis in lymph node around the cancer and peripheralblood was less obviously in laparoscopic surgery.It has more sinificance in reducing metastasis and recurrence after operation.