Changes of trauma stress and micrometastasis after laparoscopic resection in patients with colon cancer

Abstract

Objective To compare the effects of laparoscopic colon resection on trauma stress and micrometastasis in patients with colon cancer. Methods From May 2011 to May 2016, a total of ninety-eight patients admitted to People’s Hospital of Tinghu District who were diagnosed with colon cancer were selected. According to the random number, they were divided into laparoscopic group (undergoing laparoscopic colon cancer resection) and laparotomy group (treated with traditional laparotomy), with 49 patients in each group, respectively. The concentration of white blood cell (WBC), neutrophil (N), C-reactive protein (CRP), cortisol (Cor) in peripheral blood, and carcinoembryonic antigen (CEA), dopa decarboxylase (DDC) concentration in peritoneal wash fluid were detected and compared. Results (1) The length of incision, operative time, intraoperative blood loss, hospitalization time, gastrointestinal function recovery time, postoperative ambulation time and postoperative exhaust time in laparoscopic group were all better than those in the laparotomy group (all P<0.05). The incidence of complications and recurrence rate in the laparoscopy group were significantly lower than those in the laparotomy group, and the survival rate was significantly higher (χ2=8.023, 4.638, 2.368, P=0.001, 0.002, 0.004). (2) There was no significant difference in the preoperative peripheral blood stress between the two groups, but it showed significant increase at the end of the operation. WBC, Cor, and N reached the highest value 1 d after operation, while CRP 3 d after operation. The concentration of Cor in peripheral blood at 0 and 1 d after operation in the laparoscopy group was significantly lower than that in the laparotomy group (P<0.05). The concentration of CRP in peripheral blood at 1 and 3 d after operation in the laparoscopy group was significantly lower than that in the laparotomy group (P<0.05). (3) The CEA and DDC concentration (μg/L) in the two groups showed no statistical significance differences (t=1.458, 1.024, P=0.446, 0.573). At the end of the operation, CEA and DDC concentration (μg/L) in the laparoscopic group were 1 495.8±657.4, 121.5±48.6 respectively, lower than 2 873.8±1 752.1, 165.7±58.7 in the laparotomy group obviously (t=2.861, 2.534, P=0.011, 0.012). Conclusion Laparoscopic resection of colon cancer can shorten the hospitalization time, and improve the therapeutic effect and the patients’ survival rate, with small trauma and lower probability of tumor micrometastasis. Key words: Colonic neoplasms; Colectomy; Stress disorders, traumatic; Neoplasm metastasis