Comparative study on the therapeutic effects and safety between laparoscopic surgery and laparotomy in treatment of rectal cancer

HOU Zhaomin

doi:10.3969/j.issn.1002-7386.2016.23.012

Abstract：Objective To observe and compare the therapeutic effects and safety between laparoscopic surgery and laparotomy in treatment of rectal cancer .Methods Forty-eight patients with rectal cancer who underwent laparoscopic surgery in our hospital were served as observation group ,however,the other 48 patients with rectal cancer who underwent laparotomy were served as control group .The patients in control group were treated by traditional laparotomy , however , the patients in observation group were treated by laparoscopic surgery .After operation the therapeutic effects and safety were observed and compared between two groups .Results The operation time in observation group was significantly longer than that in control group,however ,the hemorrhage volume and incision length in observation group were significantly less than those in control group ( P <0.05).The patients in both groups did not undergo blood transfusion during operation .There were no significant differences in tumor size, number of cleaning lymph nodes and tumor distal excision length between two groups ( P <0.05). The postoperative analgesia , postoperative exhaust air time , the first time to get out of bed , postoperative detaining gastric tube time, postoperative time to take liquid diet , postoperative urethral catheterication time , the first time of defaecation after operation and hospital day in observation group were significantly less than those in control group ( P <0.05).The serum levels of CRP,WBC,IL-6 on 1d, 2d,3d after operation in observation group were significantly lower than those in control group ( P <0.05),however, the levels of T lymphocyte subsets-CD3+,CD4+,CD8+cells and NK cells were significantly higher than those in control group ( P <0.05).The levels of PRE,RbP on 1d, 2d,3d after operation in observation group were significantly higher than those in control group ( P <0.05), moreover, the levels of TRF,ALB on 3d after operation in observation group were significantly higher than those in control group ( P <0.05), but there were no significant differences in the other two times after operation between two groups ( P <0.05).The incidence rate of complications in observation group was significantly lower than that in control group ( P <0.05).All the patients were followed up for 12~24 months. Besides there were no significant differences in incision metastasis ,local recurrence and distant metastasis between two groups ( P >0.05).Conclusion The laparoscopic surgery in treatment of rectal cancer has the advantages of safety ,less trauma, quicker recovery , lower stress levels , which is helpful to the recovery of energy metabolism of organism and visceral protein , furthermore, which can improve life quality of patients ,thus,laparoscopic surgery is suprior to laparotomy in treatment of rectal cancer.