Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 124-133
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.124
Clinical effect of laparoscopic radical resection of colorectal cancer based on propensity score matching
Yang Liu, Xian-Xue Wang, Yu-Lin Li, Wen-Tao He, Hong Li, Hua Chen
Yang Liu, Yu-Lin Li, Wen-Tao He, Hong Li, Hua Chen, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Xian-Xue Wang, Department of Anesthesiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
Author contributions: Liu Y designed and performed the research and wrote the paper; Chen H designed the research and supervised the report; Wang XX and Li H designed the research and organized the data; Li YL and He WT designed the research and contributed to the analysis. All authors approved the manuscript.
Supported by Scientific Research Project of Hunan Provincial Health Commission, No. 202204114103.
Institutional review board statement: The study was reviewed and approved by the Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City) Institutional Review Board, Approval No. 2021-265-02.
Informed consent statement: All patients have signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The clinical data used in this study can be obtained from the corresponding author upon request at 229chenhua@sina.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua Chen, MD, Associate Professor, Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), No. 388 Renming Road, Changde 415000, Hunan Province, China. 229chenhua@sina.com
Received: November 21, 2023
Peer-review started: November 21, 2023
First decision: December 5, 2023
Revised: December 16, 2023
Accepted: December 28, 2023
Article in press: December 28, 2023
Published online: January 27, 2024
Abstract
BACKGROUND

The incidence of colorectal cancer (CRC) is increasing annually. Laparoscopic radical resection of CRC is a minimally invasive procedure preferred in clinical practice.

AIM

To investigate the clinical effect of laparoscopic radical resection of CRC on the basis of propensity score matching (PSM).

METHODS

The clinical data of 100 patients who received inpatient treatment for CRC at Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City) were analyzed retrospectively. The control group included patients who underwent open surgery (n = 43), and those who underwent laparoscopic surgery formed the observation group (n = 57). The baseline information of both groups was equipoised using 1 × 1 PSM. Differences in the perioperative parameters, inflammatory response, immune function, degree of pain, and physical status between the groups were analyzed.

RESULTS

Thirty patients from both groups were successfully matched. After PSM, baseline data showed no statistically significant differences between the groups: (1) Perioperative parameters: The observation group had a longer surgery time, less intraoperative blood loss, earlier first ambulation and first anal exhaust times, and shorter gastric tube indwelling time than the control group; (2) Inflammatory response: 24 h after surgery, the levels of interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α) between groups were higher than preoperatively. IL-6, CRP, and TNF-α levels in the observation group were lower than in the control group; (3) Immune function: At 24 h after surgery, counts of CD4-positive T-lymphocytes (CD4+) and CD4+/CD8-positive T-lymphocytes (CD8+) in both groups were lower than those before surgery, whereas CD8+ was higher than that before surgery. At 24 h after surgery, both CD4+ counts and CD4+/CD8+ in the observation group were higher than those in the control group, whereas CD8+ counts were lower; (4) Degree of pain: The visual analog scale scores in the observation group were lower than those in the control group at 24 and 72 h after surgery; and (5) Physical status: One month after surgery, the Karnofsky performance score in the observation group was higher than that in the control group.

CONCLUSION

Laparoscopic radical resection of CRC has significant benefits, such as reducing postoperative pain and postoperative inflammatory response, avoiding excessive immune inhibition, and contributing to postoperative recovery.

Keywords: Colorectal cancer, Laparoscopic, Open surgery, Inflammatory reaction, Immune function, Propensity score

Core Tip: Clinical data from 100 patients who underwent radical resection for colorectal cancer were retrospectively analyzed to compare the clinical effects of open and laparoscopic surgeries in terms of perioperative parameters, inflammatory response, immune function, degree of pain, and physical status.