Effect of laparoscopic colorectal surgery on serum creatine kinase and D-dimer in elderly patients with colorectal obstruction

Abstract

Objective To compare the incidence of early intestinal obstruction after laparoscopic and open surgery for elderly patients with colorectal cancer, and the significance of serum creatine kinase (CK) and D-dimer. Methods From January 2014 to January 2017, the clinical data of 130 elderly patients with colorectal cancer treated in Guang’an City People’s Hospital were retrospectively analyzed. The time of anal exhaust, hospitalization days and incidence of intestinal obstruction were compared between laparoscopic treatment (laparoscopic group, 60 cases) and conventional laparotomy (open group, 70 cases). Serum CK levels were measured by creatine colorimetry and D-dimer levels were measured by enzyme-linked immunosorbent assay before and after treatment in the two groups. Results (1) Compared with the open group, operation time and bleeding volume of the laparoscopic group were significantly reduced in the left hemicolon cancer radical operation, the right hemicolon cancer radical operation and the rectal cancer radical operation. The time of anal exhaust and hospitalization stay were significantly shortened, and the incidence of total intestinal obstruction was significantly reduced in the laparoscopic group (all P<0.05).(2) Intestinal obstruction occurred in 4 cases (6.7%) in laparoscopic group and 13 cases (18.6%) in open group. The incidence of total intestinal obstruction and intestinal obstruction after radical resection of left colon cancer in laparoscopic group were significantly lower than those in open group, with significant differences (χ2=4.028, 4.409, P=0.045, 0.036). (3) Serum CK and D-dimer levels were significantly lower in both groups after treatment, and CK and D-dimer levels in laparoscopic group were significantly lower than those in open group after treatment (P<0.01). (4) The levels of CK and D-dimer in patients with intestinal obstruction were significantly higher than those in patients without intestinal obstruction (t=9.235, 13.877, both P<0.01).(5) There was significant positive correlation between CK and D-dimer in patients with intestinal obstruction (r=0.852, P=0.012). Conclusions Elderly patients with intestinal obstruction after laparoscopic colorectal surgery have the advantages of lower incidence and faster recovery. Detection of serum CK and D-dimer levels can provide reference for more reasonable clinical treatment. Key words: Colorectal neoplasms; Intestinal obstruction; Laparoscopes; Creatine kinase; D-dimer