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.%目的 比较不同术式在大肠肿瘤手术中的应用效果及其对机体免疫的影响.方法 将实施大肠癌手术的123例患者分为3组,其中悬吊式腹腔镜组(悬吊组)42例,CO2气腹腹腔镜组(气腹组)41例,开腹大肠癌手术组(开腹组)40例.比较不同术式在手术时间、出血量、排气时间、标本长度、淋巴总数等方面的治疗及根治效果；以及通过ELISA方法测定血清中IgA、IgM、IgG、C-反应蛋白(C-reactive protein,CRP)含量,比较不同术式对机体免疫功能的影响.结果 悬吊组、气腹组、开腹组的手术时间分别为( 188.7 ±23.3)min,(192.5±24.0)min,( 185.9 ±30.8)min;切除标本长度分别为(20.6±1.9)cm,(21.5±3.0) cm,(21.7 ±3.2)cm;清扫淋巴结数分别为(15.3±4.3)枚,(14.8±3.4)枚,(16.8±5.6)枚,差异均无统计学意义；而术中出血量分别为( 194.0 ±79.0)mL,(187.1±80.9)mL,(231.2±67.6)mL;排气时间分别为(46.9±9.3)h,(49.1±10.3)h,(64.1±13.4)h,3组比较差异有统计学意义(P＜0.05).开腹组、悬吊组、气腹组术前IgA、IgG、IgM、CRP差异无统计学意义,而术后第3天IgM(0.69±0.15；1.15 ±0.48；0.98 ±0.42)、CRP(58.75±10.74;39.38±14.48;44.53±11.08)的比较,差异有统计学意义(P＜0.05).结论 悬吊组、气腹组及开腹组大肠癌手术在清除淋巴结数目、手术时间、切除肠管长度方面差异无统计学意义,而在手术出血量、术后排气时间以及IgM、CRP所反映的机体免疫方面,两个腹腔镜组均优于开腹手术组.
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