Objective To investigate the efficacy of different surgical methods in treatment of rectal cancer and their effects on inflammatory response,stress response and cellular immune function of patients.Methods One hundred and eight patients with rectal cancer treated at the Yellow River Sanmenxia Hospital from January 2020 to October 2022 were selected as the research subjects.The patients were divided into the laparotomy group(n=52)and the laparoscopy group(n=56)based on the surgical method.Patients in the laparotomy group were given traditional open surgery,and patients in the laparoscopy group were given laparoscopic rectal cancer radical surgery.The occurrence of postoperative incision,abdominal cavity,urinary tract and lung infection of patients in the two groups was observed.Peripheral venous blood samples of 3 mL were collected from the patiens in the two groups at 1 day before surgery and 3 days after surgery,and the serum was obtained after centrifugation.The levels of cortisol,adrenaline,noradrenaline,interleukin(IL)-6,IL-8,and tumor necrosis factor-α(TNF-α)were detected by using enzyme-linked immunosorbent assay;the C-reactive protein(CRP)level was measured by using immunoturbidimetriy assay;and the levels of CD3+and CD4+/CD8+were measured by using flow cytometry.Results The incidence of infection in the laparotomy group and laparoscopy group were 17.31％(9/52)and 3.57％(2/56),respectively;and the incidence of infection in the laparoscopy group was significantly lower than that in the laparotomy group(x2=5.561,P＜0.05).There was no significant difference in the levels of serum cortisol,adrenaline,and noradrenaline of patients between the two groups before surgery(P＞0.05).The levels of serum cortisol,adrenaline,and noradrenaline of patients at 3 days after surgery were significantly higher than those before surgery in the two groups(P＜0.05).The levels of serum cortisol,adrenaline,and noradrenaline of patients in the laparoscopy group were significantly lower than those in the laparotomy group at 3 days after surgery(P＜0.05).There was no significant difference in the levels of serum IL-6,IL-8,TNF-α,and CRP of patients between the two groups before surgery(P＞0.05).The levels of serum IL-6,IL-8,TNF-α,and CRP of patients at 3 days after surgery were significantly higher than those before surgery in the two groups(P＜0.05).The levels of serum IL-6,IL-8,TNF-α,and CRP of patients in the laparoscopy group were significantly lower than those in the laparotomy group at 3 days after surgery(P＜0.05).There was no significant difference in CD3+and CD4+/CD8+levels of patients between the two groups before surgery(P＞0.05).The levels of CD3+and CD4+/CD8+of patients in the laparotomy group at 3 days after surgery were significantly lower than those before surgery(P＜0.05);there was no significant difference in CD3+and CD4+/CD8+levels of patients in the laparoscopy group at 3 days after surgery compared with those before surgery(P＞0.05).The levels of CD3+and CD4+/CD8+of patients in the laparoscopy group were significantly higher than those in the laparotomy group at 3 days after surgery(P＜0.05).Conclusion Laparoscopy is better than laparotomy in the treatment of rectal cancer,with mild inflammatory response and little effect on the immune function of rectal cancer patients.
万方数据
