Changes Of Physiological Function Of The Immune In Patients Undergoing Laparoscopy-Assisted Colorectal Tumor Surgery During Peri-Operation Period

ObjectiveTo investigate the changes of physiological immune function of the patients undergoing laparoscopy-assisted colorectal tumor surgery during the peri-operation period.Methods86 patients with colorectal tumor undergoing elective surgery were assigned to laparoscopy-assisted group with 40 cases and conventional open abdominal group with 46 cases. Peripheral venous blood samples were taken to determine the level of C-reactive protein(CRP), immunoglobulin IgA, IgM, IgG, CD₄⁺, CD₈⁺, tumor markers carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9) and motilin(MTL), gastrin (GAS), cortisol(Cor), interleukin-6(IL-6), WBC, PLT, blood glucose at pre-operation and post-operation 1d, 3d, 8d, respectively. The venous blood detected by double antibody sandwich enzyme-linked immunosorbent assay, flow cytometry immune turbidimetric method, chemiluminescence immunoassay. The data in these different periods were anaiyzed statistically by SPSS13.0 software, then the immune and physiological responses in patients of laparoscopic surgery and traditional open surgery where analyzed lastly.Results1. Open abdominal group gurgling sound recovery time and anal exhaust recovery time was significantly longer than laparoscopy-assisted group(P<0.05). Post-operative motilin levels of the open abdominal group decreased significantly(P<0.05), no significant changes after the laparoscopy-assisted group(P>0.05), The two groups in the same period of post-operative 1d, 3d, 8d a significant difference(P>0.05). The two groups gastrin were significantly higher than postoperative (P<0.05), then decreased. At the post-operation 8d was basically returned to preoperative levels. In the same period between the two groups had no statistical significance (P> 0.05).2. The decreased of CD₄⁺ the two groups at the post-operation 1d was significantly (P<0.05). The different of CD₈⁺ between the two groups at the post-operation 8d was significantly (P<0.05).3. Compared with the level of IgA, IgM, IgG at pre-operation, that at post-operation decreased significantly in both groups (P<0.05). At the post-operation 8d was basically returned to preoperative levels. Postoperative CRP levels were significantly higher (P<0.05), then gradually reduced, in the same period between the two groups had no statistical significance (P> 0.05).4. The two groups postoperative CEA were significantly lower than preoperative (P <0.05), in the same period between the two groups had no statistical significance (P>0.05). Postoperative CA19-9 decreased slightly compared with the preoperative (P>0.05). Compared the two groups were not statistically significant at the post-operation (P>0.05).5. Postoperative cortisol levels were significantly higher(P<0.05), at the post-operation 3d the open abdominal group was significantly greater than the laparoscopy-assisted group (P<0.05), at the post-operation 8d the two groups returned to preoperative levels. Preoperative IL-6, blood glucose were no statistical significance (P>0.05), the level of IL-6, blood glucose were significantly higher than preoperative levels (P<0.05), then decreased, the level of blood glucose at the post-operation 1d laparoscopy-assisted group increase was significantly less than the open abdominal group (P <0.05). At the post-operation 8d, the level of IL-6 decreased as that at the pre-operation of the laparoscopy-assisted group, but it was still higher than that at the pre-operation of the open abdominal group, and the difference between the two groups was statistically significant at the same period(P<0.05).6. The two groups blood WBC was significantly higher compared with the pre-operative. At the post-operation 1d, the open abdominal group was significantly higher than the same period in laparoscopy-assisted group (P<0.05), followed by the two groups gradually returned to pre-operative levels. Compared with the level of PLT at pre-operation, that at post-operation decreased significantly in both groups (P<0.05). At the post-operation 8d the two groups returned to preoperative levels. And the laparoscopy-assisted group was significantly higher than the same period open abdominal group (P<0.05).ConclusionThe immune function and physiological function in patients with can be partly preserved during postoperative period. Compared to conventional open abdominal surgery, Laparoscopy-assisted colorectal cancer surgery has greater advantages in the immune function and physiological responses.