The Clinical Correlated Analysis And Study Of The Laparoscopic Colorectal Cancar Radical Resection And The Micrometastasis

Object: The incidence of colorectal cancer has been increasing year by year. With the improvement of laparoscopic instruments and the vigorous development of laparoscopic technique, the laparoscopic colorectal cancer radical resection became actual. The excellences such as microtrauma , good operative view , little incision , short recovery time of laparoscopic just make up the shortcoming of conventional open operation. But the arguments about the cancer radical effect of the laparoscopic still exist. On some studies the colorectal cancer patients beyond Dukes C indicated that the area and amount of eliminated lymph nodes and the length of excised neoplastic intestinal canal have no significant difference between the laparoscopic and the open. In order to observe the effect of the laparoscopic colorectal cancer radical operation further, our study detect the influence of the laparoscopic and the open colorectal radical operation on the micro-metastasis ,and discover the difference is significant or not.Methods: During the April 2003 to December 2004, from the patients with different position colorectal cancer beyond Dukes C stage who were performed laparoscopic radical operation random draw 20 patients as experiment group, and from patients with different position colorectal cancer beyond Dukes C patients who were performed open radical operation 20 patients took randomly as contrast group. We draw thepatients blood about 5 ml from antecubital vein at the time before and after the operation about 30 minutes respectively, preserved the blood in deep hypothermia circumstance,cytrokeratin-20(CK-20) as the micrometastasis maker, using the RT-PCR technique,G3PDH as the intra-contrast gene, quantitatively detect the amounts of CK-20 in the blood with the gelatum imagery system and the computer analyzing software on the gelatum imagery system ,in order to compare the influence of the laparoscopic and the open operation on the micrometastasis.Results: The CK-20 of all 40 cases could be detected respectively. The differences of the CK-20 amounts between the different ages,different histology categories,different tumor location had no significance(P>0.05). But the difference between different clinical Dukes stages had significance(P<0.01).The amounts of CK-20 of all cases increase after the operation respectively and the increment had statistics significance(P<0.05) and the increment has the positive correlation with the operation time(P<0.05).The difference of increment between the experiment group and the contrast group had statistical significance too(P<0.01).The influence of age> histology category n tumor location > clinical Dukes staging on the increment had no statistical significance(P>0.05). Conclusion: The tumor stages befor operation and the duration ofoperation have significant influence on the tumor micrometastasis . Thelaparoscopic colorectal cancer radical resection is a microtraumatic^ safe^effective therapeutic measure.