Laparoscopic Radical Resection versus Routine Surgery for Colorectal Cancer

Abstract

For patients with colorectal cancer, minimally invasive surgical methods, particularly laparoscopic methods, are now the preferred course of therapy. This research is performed to investigate the effects of laparoscopic radical resection on patients with colorectal cancer. A total of 100 colorectal cancer patients treated in our hospital from January 2017 to January 2019 were enrolled. The subjects were divided into observation ( n = 50 ) and control ( n = 50 ) groups and treated with laparoscopic surgery and laparotomy, respectively. As well as postoperative complications and survival rates, the levels of inflammatory substances, stress response, immunological function, and perioperative markers were compared between the two groups. There was no significant difference in the postoperative exhaust time between the two groups ( P > 0.05 ). Compared with the control group, the observation group showed longer operation time, faster recovery of intestinal function, shorter hospital stay, and less intraoperative bleeding amount ( P < 0.05 ). The serum contents of hs-CRP, TNF-α, IL-6, norepinephrine, adrenaline, and cortisol at 1 d, 3 d, and 5 d after surgery were significantly higher than before in both groups ( P < 0.05 ). Moreover, the serum contents of hs-CRP, TNF-α, IL-6, norepinephrine, adrenaline, and cortisol in the observation group were significantly lower than that in the control group ( P < 0.05 ). At 10 days following surgery, immune index levels had dramatically increased in both groups, with noticeably higher immune index levels in the observation group than in the control group ( P < 0.05 ). There were no appreciable differences in the two groups’ 2-year survival rates ( P > 0.05 ), but the complication rate was much greater in the control group ( P < 0.05 ). To sum up, after laparoscopic surgery, patients had fewer complications, shorter hospital stay, lower inflammatory factor expression, less stress response, better immune function, less trauma, faster recovery, and improved quality of life.

Clinical effect of laparoscopic radical resection of colorectal cancer based on propensity score matching

“…This indicates that laparoscopic surgery may reduce the early postoperative inflammatory response compared to open surgery. This is consistent with the results reported by Chen et al [ 10 ]. At the same time, surgical trauma can also cause the temporary inhibition of immune function[ 21 ].…”

“…Surgery is the only curative treatment for CRC[ 10 ]. Open radical resection for CRC has a long history of clinical application.…”

Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short‐term complications in elderly patients with colorectal cancer

“…Surgical resection is the most common treatment method used for colorectal cancer, but it also leads to a large increase in the number of inflammatory cells and an increased stress response, 18,19 which are the main factors affecting the prognosis of patients 20 . CRP, procalcitonin, TNF‐α, IL‐6, IL‐10, and WBC have been used as the most common markers of inflammatory stress, 21–23 and Chen used these indices to compare the efficacy of laparoscopic surgery and conventional surgery in the treatment of colorectal cancer 24 . In Wang's research, patients in the ERAS group had lower serum levels of TNF‐αIL‐6 and CRP as compared to those of the patients in the non‐ERAS group 25 .…”

“…20 CRP, procalcitonin, TNF-α, IL-6, IL-10, and WBC have been used as the most common markers of inflammatory stress, [21][22][23] and Chen used these indices to compare the efficacy of laparoscopic surgery and conventional surgery in the treatment of colorectal cancer. 24 αIL-6 and CRP as compared to those of the patients in the non-ERAS group. 25 By analyzing postoperative indices such as CRP levels, Zhao believed that ERAS could effectively and safely inhibit the postoperative stress response in patients with gastric cancer.…”

Prediction model of stress ulcer after laparoscopic surgery for colorectal cancer established by machine learning algorithm

“…CRC kills over 900000 individuals worldwide each year, which makes it the fourth most lethal cancer[ 3 ]. Due to the advantages of low trauma, aesthetic criteria, and rapid postoperative recovery, laparoscopic radical dissection of CRC has emerged as the primary treatment for this disease[ 4 , 5 ]. However, CO 2 pneumoperitoneum, hemodynamic changes, local immune dysfunction and other reasons may lead to changes in neuroendocrine metabolism in patients, causing a significant stress response[ 6 , 7 ].…”