A controlled study of the effects of laparoscopic radical resection of colon cancer on the shedding of peritoneal and intestinal cancer cells and peritoneal fibrinolysis in patients with locally advanced colon cancer / 中国医师进修杂志

ABSTRACT

Objective:To investigate the effect of laparoscopic radical resection of colon cancer on the shedding of cancer cells in the abdominal cavity and intestinal cavity and peritoneal fibrinolysis in patients with locally advanced colon cancer, to provide a reference for treatment.Methods:From March 2018 to May 2020, 76 patients with locally advanced colon cancer in Wanbei Coal and Electricity Group General Hospital were selected and divided into group A (33 patients) and group B (43 patients) according to different treatment procedures. Group A underwent laparoscopic radical resection of colon cancer, group B underwent open radical resection of colon cancer. The related indexes, complications, and serum immune function indexes (CD 4+, CD 8+, CD 4+/CD 8+) before operation and 1 d and 3 d after operation, peritoneal fibrinolytic function indexes of the peritoneal tissue: peritoneal tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), the positive rate of peritoneal cancer cell shedding at the beginning of the operation and immediately after the operation, the positive rates of intestinal cancer cell shedding before and immediately after surgery were compared between the two groups. Results:Although the operation time of group A was longer than that of group B: (186.21 ± 24.07) min vs. (149.49 ± 17.82) min, the postoperative anal exhaust time and hospital stay were shorter than those of group B: (3.32 ± 0.75) d vs. (3.84 ± 1.02) d, (10.62 ± 1.74) d vs. (12.85 ± 2.26) d, and the amount of intraoperative blood loss was less than that of group B: (102.08 ± 16.39) ml vs. (159.50 ± 23.14) ml, the differences were statistically significant ( P<0.05). The complication rate of group A was lower than that of group B: 9.09% (3/33) vs. 27.91%(12/43)( P<0.05). Serum CD 4+, CD 8+, CD 4+/CD 8+ levels in the two groups at 1 and 3 days after operation were lower than those before the operation, but those in group A were higher than those in group B ( P<0.05). The t-PA level of the peritoneal tissue immediately after the operation in the two groups was lower than that at the beginning of the operation, but that in group A was higher than that in group B. The level of PAI-1 was higher than that at the beginning of the operation, but the level of PAI-1 in group A was lower than group B ( P<0.05). There was no significant difference in the positive rate of cancer cells in the abdominal cavity and intestinal cavity at each time point in the two groups ( P>0.05). Conclusions:Application of laparoscopic radical resection of colon cancer for locally advanced colon cancer can reduce surgical trauma, promote postoperative recovery, reduce complications, reduce the impact on the body′s immune function and peritoneal fibrinolytic function, and does not increase the risk of shedding cancer cells in the abdominal cavity and intestinal cavity after surgery.