Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4042-4049
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4042
Comparison of clinical efficacy and postoperative inflammatory response between laparoscopic and open radical resection of colorectal cancer
Long-Hai He, Bo Yang, Xiao-Qin Su, Yue Zhou, Zhen Zhang
Long-Hai He, Bo Yang, Zhen Zhang, Department of General Surgery, The First People’s Hospital of Wanzhou District, Chongqing 404040, China
Xiao-Qin Su, Yue Zhou, Department of Clinical Nutrition, The First People’s Hospital of Wanzhou District, Chongqing 404040, China
Author contributions: He LH and Yang B design the experiment; Su XQ drafted the manuscript; Zhou Y, Zhang Z and He LH collected the data; Yang B and Su XQ analyzed and interpreted data; Zhou Y, Zhang Z and He LH wrote and revised the manuscript.
Institutional review board statement: This study was approved by the First People’s Hospital of Wanzhou District Ethics Committee.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declared that there is no conflict of interest between them.
Data sharing statement: No additional data are available.
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: Long-Hai He, BM BCh, Associate Chief Physician, Department of General Surgery, The First People's Hospital of Wanzhou District, No. 388 East Tiancheng Road, Wanzhou District, Chongqing 404040, China. helh2021@163.com
Received: December 1, 2021
Peer-review started: December 1, 2021
First decision: December 27, 2021
Revised: January 18, 2022
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: May 6, 2022
Abstract
BACKGROUND

In recent years, the incidence of colorectal cancer (CRC) has increased annually, which has seriously threatened the health and quality of life of patients. In the treatment of CRC, both laparoscopic and radical resection are widely used.

AIM

To explore and discuss clinical efficacy and postoperative inflammatory response of laparoscopic and open radical resection of CRC.

METHODS

A total of 96 patients with CRC diagnosed in our hospital from March 2016 to April 2021 were selected, and were divided into the study group (n = 48) and control group (n = 48) using a simple random method. The control group was treated with open radical resection of CRC, and the study group was treated with laparoscopic radical resection of CRC. The perioperative conditions (operation time, intraoperative blood loss, the recovery time of gastrointestinal function, number of lymph node dissections and length of hospital stay), inflammatory response index levels [interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP)] before and after operation, pain stress response indices [levels of neuropeptide (NPY), prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT)], and the incidence of the complications between the two groups were counted.

RESULTS

The operation time in the study group was (186.18 ± 33.54 min), which was longer than that of the control group (129.38 ± 26.83 min), but the intraoperative blood loss (111.34 ± 21.45 mL), recovery time of gastrointestinal function (25.35 ± 4.55 h), and hospital stay (10.09 ± 2.38 d) were better than those in the control group (163.77 ± 32.41 mL, 36.06 ± 7.13 h, 13.51 ± 3.66 d) (P < 0.05). There was no significant difference in the number of lymph node dissections between the study group (15.19 ± 3.04) and the control group (16.20 ± 2.98) (P > 0.05). There was no significant difference between the levels of serum IL-6 (9.79 ± 4.11 ng/mL), IL-8 (3.79 ± 1.71 ng/L), IL-10 (48.96 ± 12.51 ng/L) and CRP (7.98 ± 2.33 mg/L) in the study group and the control group (10.56 ± 3.78 ng/mL, 4.08 ± 1.45 ng/L, 50.13 ± 11.67 ng/L, 8.29 ± 2.60 mg/L) before the operation (P > 0.05). After the operation, there was no significant difference between the levels of serum IL-6 (19.11 ± 6.68 ng/mL). There was no significant difference in serum NPY (109.79 ± 13.46 UG/L), PGE2 (269.54 ± 37.34 ng/L), 5-HT (151.70 ± 18.86 ng/L) between the study group and the control group (113.29 ± 15.01 UG/L, 273.91 ± 40.04 ng/L, 148.85 ± 20.45 ng/L) before the operation (P > 0.05). The incidence of the complications in the study group (4.17%) was lower than that of the control group (18.75%) (P < 0.05).

CONCLUSION

Laparoscopic radical resection of CRC can reduce surgical trauma, inflammatory response and pain stress caused by surgery, which shortens rehabilitation of patients, with a low incidence of complications.

Keywords: Laparoscope, Open surgery, Colorectal cancer, Inflammatory response, Pain stress response

Core tip: Through a set of retrospective studies, it was confirmed that laparoscopic radical resection of colorectal cancer can reduce surgical trauma, inflammation and pain stress caused by surgical treatment, and help shorten the recovery process of patients, with low complication rate, and safety is good.