Effect of laparoscopic surgery with various approaches on intestinal barrier function and red blood cell immunity in patients with right hemicolectomized colon cancer
Objective To compare the effects of laparoscopic surgery with various approaches on intestinal barrier function,red blood cell immunity,and prognosis in patients with right hemicolectomized colon cancer.Methods A prospective selection of 110 patients with right hemicolectomized colon cancer admitted to our hospital from April 2019 to April 2021 was conducted.Patients were divided into groups A(n= 55)and B(n= 55)using a simple randomization method.During the treatment period,two cases of loss of follow-up occurred in Group A and three in Group B.Finally,53 from Group A and 52 participants from Group B completed the study.Both groups underwent laparoscopic surgery.Group A underwent a cephalic approach,whereas Group B underwent an intermediate approach.The periopera-tive indexes,complications,prognosis,intestinal barrier function(endotoxin,D-lactic acid,and diamine oxidase),red blood cell immune complex rate(RBC-ICR),RBC-C3b receptor rosette rate(RBC-C3bRR),and erythrocyte adhesion to tumor cell rosette rate(TRR)of the two groups were determinedd.Results Group A had less intraoperative bleeding,shorter central lymph node dissection time,shorter operative time,and lower complication rate(P<0.05)than Group B.Endotoxin,diamine oxidase,and D-lactate levels in both groups were higher 3 d after surgery than before surgery(P<0.05).Three days after surgery,the RBC-ICR of both groups was higher than before surgery,whereas the TRR and RBC-C3bRR were lower than before surgery(P<0.05).After 1 year of follow-up,no statistically sig-nificant difference in distant metastasis,local recurrence,and survival rates were observed between the two groups(P>0.05).Conclusion The two approaches used in this study have similar effects in right hemicolectomized colon cancer.The cephalic approach for laparoscopic sur-gery shortened the surgical time and reduced complications.
right colon cancerlaparoscopic surgeryintermediate approachhead side approachintestinal barrier functionprognosis