Comparison of short-term rehabilitation and long-term prognosis between laparoscopy and traditional laparotomy for colon cancer / 中国医师进修杂志

ABSTRACT

Objective:To compare the short-term recovery and long-term prognosis of patients with colorectal cancer by laparoscopy and traditional open surgery.Methods:The clinical data of 86 patients with colon cancer treated by the Changshu NO.1 People′s Hospital from April 2017 to April 2019 were retrospectively analyzed. According to different surgical methods, they were divided into observation group (laparoscopic radical resection of colon cancer, 41 cases) and the control group (traditional laparotomy underwent radical resection of colon cancer, 45 cases). The surgical indicators, short-term recovery, complications, serum anti-inflammatory and pro-inflammatory factor levels, and 3-year tumor-free survival rate between two groups were compared.Results:Compared with the control group, the observation group had less intraoperative blood loss and shorter hospital stay (120.32 ± 32.43) ml vs. (178.43 ± 39.98) ml, (9.65 ± 2.17) d vs. (12.35) ± 2.68) d; the time to get out of bed for the first time, the time of anal exhaust and the time of eating semiliquid in the observation group were earlier (2.10 ± 0.23) d vs. (3.03 ± 0.54) d, (3.45 ± 1.02) d vs. (4.29 ± 1.03) d, (4.54 ± 1.09) d vs. (5.30 ± 1.05) d, the differences were statistically significant ( P<0.05). The incidence of complications in the observation group was lower than that in the control group 12.20% (5/41) vs. 31.11% (14/45), the difference was statistically significant ( χ2 = 4.695, P<0.05). Serum interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels in the observation group were lower than those in the control group (23.12 ± 6.09) μg/L vs. (31.05 ± 5.3) μg/L, (57.87 ± 10.6) μg/L vs. (62.43 ± 6.8) μg/L; serum IL-4 and transforming growth factor (TGF)-β levels were higher than those in the control group (155.03 ± 14.53) ng/L vs. (127.87 ± 12.09) ng/L, (26.32 ± 3.09) ng/L vs. (20.87 ± 3.87) ng/L, the differences were statistically significant ( P<0.05). There was no significant difference in the tumor-free survival rate between the two groups at 3-year after operation ( P>0.05). Conclusions:Laparoscopic treatment of colon cancer has the advantages of less trauma, fewer complications, and mild postoperative inflammatory reaction, and has a long-term prognosis comparable to traditional laparotomy.