Effect of laparoscopic radical operation on colorectal cancer patients and its impact on inflammatory response and stress response / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of laparoscopic radical operation on patients with colorectal cancer and its impact on inflammatory factors and stress response.Methods:The clinical data of 72 patients with colorectal cancer treated in Jiande First People′s Hospital from March 2018 to March 2020 were analyzed. The patients were divided into the observation group (36 cases) and the control group (36 cases) according to different surgical methods. The observation group received laparoscopic radical operation, while the control group underwent open radical operation. The postoperative complications, gastrointestinal function recovery, and perioperative indexes and the changes of inflammatory reaction indexes C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6(IL-6), and stress response indexes noradrenaline (NE), cortisol (Cor) before operation and 3 d after operation were compared between the two groups.Results:The postoperative complications rate in the observation group was lower than that in the control group: 11.11%(4/36) vs. 33.33%(12/36), and the difference was statistically significant ( χ2 = 5.143, P<0.05). The time to start eating, exhaust time and recovery time of bowel sounds in the observation group were shorter than those in the control group: (2.15 ± 0.38) d vs. (3.89 ± 0.56) d, (2.39 ± 0.34) d vs. (3.58 ± 0.62) d, (2.56 ± 0.43) d vs. (3.81 ± 0.57) d, and the differences were statistically significant ( t = 15.427, 10.098, 10.504, P<0.05). The hospitalization time in the observation group was shorter than that in the control group [(12.38 ± 3.29) d vs. (18.74 ± 4.15) d], the intraoperative blood loss was less than that in the control group [(93.17 ± 16.52) ml vs. (158.93 ± 21.09) ml], the operation time was longer than that in the control group [(185.63 ± 23.14) min vs. (129.90 ± 18.76) min ], and the differences were statistically significant ( t = 7.206, 14.728, 11.225, P<0.05). Three days after operation, the levels of CRP , TNF-α and IL-6 in the observation group were lower than those in the control group: (17.84 ± 3.87) mg/L vs. (32.16 ± 5.64) mg/L, (307.12 ± 15.64) ng/L vs. (369.84 ± 21.25) ng/L , 84.62 ± 5.89) ng/L vs. (98.93 ± 7.74) ng/L, and the differences were statistically significant ( t = 12.561, 14.263, 8.828, P<0.05). Three days after operation, the levels of NE and Cor in the observation group were lower than those in the control group: (187.34 ± 14.62) ng/L vs. (235.27 ± 19.83) ng/L, (103.24 ± 12.09) μg/L vs. (147.86 ± 20.12) μg/L, and the differences were statistically significant ( t = 11.673, 11.405, P<0.05). Conclusions:Laparoscopic radical operation has obvious effect on patients with colorectal cancer. It can shorter the recovery time of bowel function, and has less postoperative complications, little influence on inflammatory reaction and stress response.