Compare the Effects of Three Hole NOSES and Five Hole LRR on Perioperative Indicators and Serum Inflammatory Factors in Patients with Rectal Cancer

LI Haichun; XU Jialiang; XIAO Lei

doi:10.3969/j.issn.1004-437X.2025.23.013

Abstract：Objective To compare the effect of three hole laparoscopy with natural orifice specimenextraction surgery(NOSES)and laparoscopic radical resection(LRR)in the treatment of patients with rectal cancer and its influence on perioperative indicators and serum inflammatory factor levels.Methods From April 2022 to April 2024,the clinical data of 96 patients with rectal cancer in Xinyang Central Hospital were retrospectively collected,and they were divided into two groups according to the operation schemes.The 48 patients who received three hole NOSES treatment were included in the observation group,and the 48 patients who received five hole LRR treatment were included in the control group.The perioperative and postoperative recovery indexes of the two groups were compared,as well as the levels of tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen(CA)242,CA724],inflammatory factors[interleukin-6(IL-6),IL-10,C reactive protein(CRP)],serum protein and ionic[albumin(ALB),total protein(TP),sodium ion(Na+)]before and 1 day after operation,and the incidence of complications of the two groups was also compared.Results There was no significant difference in the number of lymph node dissection between the two groups(P＞0.05).Compared with the control group,the observation group had less intraoperative blood loss,shorter use of analgesic pump,shorter first eating and first exhaust time,and longer operation time(P＜0.05).Compared with before operation and 1 day after operation,the levels of serum CEA,CA242,CA724 of the two groups were decreased(P＜0.05),but there was no significant difference between the two groups(P＞0.05).Compared with before operation and 1 day after operation,in two groups,the level of serum IL-10 was decreased,the levels of IL-6,CRP were increased,but the level of serum IL-10 in the observation group was higher than that in the control group,the levels of IL-6,CRP were lower than those in the control group(P＜0.05).Compared with before operation and 1 day after operation,in two groups,the levels of serum ALB,TP,Na+were decreased,the levels of serum ALB,TP,Na+in the observation group were higher than those in the control group(P＜0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Five hole LRR and three hole NOSES in the treatment of rectal cancer patients can significantly reduce the level of tumor markers,and the effect is similar,but the former has shorter operation time,the latter has lower intraoperative blood loss and complication risk,faster postoperative recovery,and helps to reduce the surgical trauma and the impact on the third space effect.