关键词: 大肠癌, 气腹腹腔镜手术, 腹壁悬吊腹腔镜手术, 开腹手术

Abstract: Objective To compare the effects of different surgical methods in treatment of colorectal cancer and on immune function. Methods From June 2006 to January 2011, 123 cases of colorectal cancer were treated in the department, 40 of whom received open surgery, and 42 patients received abdominal lifting laparoscopic surgery and 41 patients received carbon dioxide pneumoperitoneum laparoscopic surgery. The therapeutic efficacy, operation time, blood loss, the first exhaust time, the length of specimen and the total number of lymph nodes were compared. In addition, the serum level of IgA, IgM, IgG, C-reactive protein (CRP) in peripheral blood were assayed by ELISA, which might reflect the effects of different surgery on human immune function.Results In abdominal lift laparoscopic group, pneumoperitoneum laparoscopic group and open surgery group, the operation time was (188.7±23.3)min, (192.5±24.0)min and (185.9±30.8)min, the length of specimen was (20.6±1.9)cm, (21.5±3.0)cm and (21.7±3.2)cm, the total number of lymph nodes dissected was (15.3±4.3,14.8±3.4 and 16.8±5.6) and there was no significant difference in the aspects mentioned above (P>0.05). However, the intraoperative blood loss [(194.0±79.0)mL, (187.1±80.9 )mL, (231.2±67.6)mL] and the first exhaust time after operation [(46.9±9.3)h, (49.1±10.3)h, (64.1±13.4)h], both showed significant different (P<0.05). In addition, the three groups of patients had no significant deviation in IgA、IgG, IgM and CRP before operation. But three days after operation, IgM (0.69±0.15;1.15±0.48;0.98±0.42) and CRP(58.75±10.74;39.38±14.48;44.53±11.08) had significant difference. Conclusion Among the three groups, there was no significant difference in the number of lymph nodes dissected, operation time and the length of specimen. However, in the aspect of blood loss, the first exhaust time, IgM and CRP that reflect the immune response, the two laparoscopic groups were better than the open surgery group.

Key words: colorectal cancer, pneumoperitoneum laparoscopic surgery, abdominal lift laparoscopic surgery, open operation