The pre- and postoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: The comparison of laparoscopy and laparotomy in colorectal cancer patients.

Abstract

The management of inflammation after colorectal surgery is important to decrease the susceptibility to postoperative complications. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood are known as two important inflammatory markers. In this study we evaluated and compared colorectal laparoscopy and laparotomy based on the PLR and NLR. Totally, 76 patients were divided into two groups including patients who underwent laparoscopy (45 cases) or laparotomy (31 cases). The PLR and NLR were calculated based on cell blood count analysis of preoperative and postoperative day (POD) one and three in both groups. Statistical analysis was performed using SPSS software version 22. The PLR and NLR have no significant association with age, gender and tumor site (p> 0.05). However, both ratios were significantly increased in laparotomy patients at POD1 compared with the laparoscopy patients (p< 0.05). According to the two by two comparisons, the preoperative and postoperative PLR were significantly different in the laparotomy group (p< 0.05) but not in the laparoscopy group (p> 0.05). However, the preoperative and postoperative NLR were significantly different in both laparoscopy and laparotomy groups (p< 0.05). The NLR and PLR markers indicated that laparoscopy can be a better choice for colorectal surgery due to lower induction of inflammation compared with laparotomy.