Clinical Study On The Effect Of Laparoscopic And Open Radical Colon Cancer Radical Surgery On Body Inflammatory Reaction

ObjectiveWith the continuous development of modern medical technology,the number of patients undergoing laparoscopic surgery for colorectal cancer has been increasing year by year,and has been extended to the vast majority of primary hospitals in the past 10 years.Compared with laparotomy,laparoscopic surgery is more difficult to operate,and more tissues to dissected and cut,and the time of operation and anesthesia is prolonged.Whether laparoscopic radical resection for colorectal cancer is more "micro-invasive" than open surgery remains controversial.Therefore,in our study,we compared the changes of the systemic and local inflammatory factors after surgery by comparing the two surgical methods.From the perspective of inflammation,we investigated the effect of laparoscopic radical resection of colorectal cancer versus open surgery on the trauma of the body.MethodsA total of 121 patients with colorectal cancer who were in our hospital from September 2015 to September 2017 are selected.According to the patient's medical history,physical examination,and imaging findings,we initially considered the location of colorectal cancer as malignant lesions,in which accordance with laparoscopic colorectal surgery.The radical indications for radical operation were based on the number of hospital admissions.The patients were divided into the laparoscopic group and the open abdominal group which adopt the Laparoscopic radical resection and the radical resection.At the beginning of the operation,all patients were treated with peritoneal lavage.WBC,CRP,TNF-?,IL-6,IL-10,and fibrin were measured in the peritoneal lavage fluid.WBC,CRP,TNF-?,il-6,il-10 and fibrin were detected 24 hours and 72 hours after surgery.All patients received elbow veins on the day of surgery,24 hours and 72 hours after operation in order to detect WBC,CRP,TNF-?,IL-6,IL-10 and fibrin levels.Observe the dynamic changes of the above indicators,compare the levels of inflammation indicators at different time points in the two groups of patients;routine follow-up of the two groups after surgery,and collect postoperative adhesion intestinal obstruction and tumor recurrence.ResultsIn the laparoscopic group,17 patients had late staging of surgical exploration.3 patients had open surgery due to the location of the tumor adjacent to the tumor during the operation.2 patients had lower rectal tumors and received transabdominal perineal resection.3 Cases had poor basal conditions or inadequate gastrointestinal tract preparation prior to ileostomy.2 patients had persistently high fever after surgery.Exclude all the above patients and remaining 34 patients.In the open group of 60 patients,18 patients had an intraoperative tumor detection staging too late,4 patients had a rectal tumor with a low level of transabdominal perineal resection,and 4 patients had poor basal conditions or preoperative gastrointestinal tract preparation.The ileostomy was fully performed.One patient developed persistent hyperthermia after surgery.One patient developed postoperative lung infection and exclude the above patients and remaining 32 patients.1.There was no significant difference between the two groups in terms of operation time,tumor margin distance,number of lymph nodes removed(P>0.05).2.The amount of blood loss,the recovery time of intestinal peristaltic function and the length of hospital stay in the laparoscopic group were lower than that in the open group,and the difference was statistically significant(P<0.05).3.There was no significant difference in WBC counts,CRP concentrations,TNF-? concentrations,IL-6 concentrations,IL-10 concentrations,and fibrin in the preoperative peripheral blood between laparoscopic group and open group(P>0.05).The WBC count,CRP concentration,TNF-? concentration,IL-6 concentration,and fibrin in the peripheral blood of the group were lower than those in the open group at 24 hours and 72 hours after surgery,and the difference was statistically significant(P<0.05).There was no significant difference in IL-10 concentrations between the two groups at 24 hours and 72 hours after surgery(P>0.05).4.The WBC count,CRP concentration,TNF-? concentration,IL-6 concentration,IL-10 concentration and fibrin of the two groups had no statistical difference(P>0.05).The WBC counts,CRP concentrations,and IL-6 concentrations and fibrin in the laparoscopic group were lower than those in the open group at 24 hours after operation(P<0.05).The WBC count,TNF-? and il-6 concentration concentration in the 72-hour peritoneal drainage fluid in the laparoscopic group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the postoperative CRP concentration between the two groups after 72 hours(P>0.05).5.The follow-up time was 6 to 24 months after discharge of the two groups.There were 2 patients with adhesive intestinal obstruction and 2 patients with postoperative recurrence after laparoscopic surgery,and there were 4 patients with adhesion intestinal obstruction and 2 patients postoperative recurrence after operation in the open group.There were no significant differences between the two groups in postoperative patients with concurrent intestinal obstruction and recurrence(P>0.05).ConclusionsLaparoscopic radical resection for colorectal cancer has less bleeding,less postoperative pain and quick recovery,is safe and feasible,and can achieve the same radical effect as laparotomy.Proficient in the peripheral blood vessels,bone and other microscopic anatomy,composed of stable and tacit understanding of the surgical team,help to shorten the learning curve,reduce the incidence of complications.