Laparoscopic total mesorectal excision for colon cancer and its influence on inflammatory factors and T lymphocyte subtypes
HUANG Jiang
FAN Hua
LEI Xing
GAO Yongtao
CHANG Qi
Abstract：Objective To observe the effect of different surgical treatment of colon cancer,and compare their impact on inflammatory indicators,stress indicators and immune indicators. Methods Ninety-six patients with colon cancer were di-vided into observation group (48 cases) and control group (48 cases). The patients of observation group were treated with laparoscopic complete mesocolic excision,while the patients of control group were treated with open total complete mesocolic excision. The general operation condition,the number of lymph node dissection, the indexes of inflammatory stress such as CRP, IL-6, HMGB-1, MCP-1, BG, glucagon, immune index CD4 +, CD8 +, NK cells and postoperative complications of two groups were compared and analyzed. Results The intraoperative bleeding,postoperative exhaust time,liquid diet time,post-operative drainage,hospital stay in the observation group were significantly lower than those in the control group (t= 5. 793, t=3. 405, t=2. 259, t=3. 945, t=7. 935, P= 0. 000, P=0. 000, P=0. 041, P=0. 000, P=0. 000), while there was no significant difference between the two groups in operation time (t=0. 294, P= 0. 385). The number of stage Ⅲ lymph-adenectomy, the number of positive lymph node dissection, the number of left colon lymphadenectomy,the number of right co-lon lymphadenectomy in the observation group were significantly higher than those in the control group ( t = 19. 686, t =19. 878,t=4. 509,t=9. 269,P= 0. 000,P=0. 000,P=0. 000, P=0. 000), while there was no significant difference be-tween the two groups in I,Ⅱlymphadenectomy quantity (t= 1. 630, t=1. 335, P= 0. 051, P=0. 053). The CRP, IL-6 in the observation group were significantly lower than those in the control group (t= 6. 376, t=4. 986, P= 0. 000, P=0. 000). The HMGB-1, MCP-1, BG, glucagon in the observation group were significantly lower than those in the control group ( t=21. 739, t=17. 802, t=9. 385, t=18. 329, P= 0. 000, P=0. 000, P=0. 000, P=0. 000). The CD4 +, CD8 +, NK cells levels in the observation group were significantly better than those in the control group (t= 2. 066, t=6. 004, t=2. 080, t=1. 963, P=0. 021, P=0. 000, P=0. 037, P=0. 041). There were incision infection,residual abdominal infection,pulmona-ry infection,anastomotic bleeding and other adverse complications occurred in both two groups,and the difference between the two groups were statistically significant (x2= 7. 992, x2=5. 879, x2=3. 899, x2=4. 290, P= 0. 005, P=0. 015, P=0. 048, P=0. 038), but the difference between groups in the incidence of incomplete intestinal obstruction and deep vein thrombosis were not statistically significant (x2= 2. 840, x2=0. 723, P= 0. 092, P=0. 395). Conclusion Compared with laparotomy,patients with colon cancer undergo laparoscopic complete mesocolic excision can reduce surgical trauma,body irritation,and less affect the immune function,which is conducive to the prognosis of patients.
Keywords：Colon cancerLaparoscopyComplete mesocolic excisionInflammatory indexImmune index
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 697-701 )