Clinical Analysis Of Laparoscopy Combined With Colonoscopy In Colorectal Cancer

Background: Laparoscopic surgery for colorectal cancer is effective,and "surgical vision clear,trauma,rapid recovery after surgery" and other advantages,but it can not become a standardized treatment of colorectal cancer,a single surgical model.The reason may be laparoscopic surgery is mainly based on laparoscopic imaging information such as bowel volume changes,intestinal serosal invasion,local lymph nodes and other circumstances to determine the condition,and the lack of "hand" fine tactile.For most of the smaller tumor size of colorectal cancer patients,intraoperative difficult to accurately determine the location of the tumor,it is difficult to determine the precise surgical resection range,may cause "inadequate treatment" or "over-treatment" consequences.In this study,we compared the efficacy of laparoscopic surgery combined with endoscopic surgery and simple laparoscopic surgery for colorectal cancer.The aim of this study was to investigate the safety and efficacy of laparoscopic combined colonoscopy in the treatment of colorectal cancer.MATERIALS AND METHODS: Retrospective analysis of January 2011 to December 2015 Guigang City People’s Hospital gastrointestinal surgery in186 cases of colorectal cancer patients with clinical data.Among them,84 cases were treated by laparoscopy combined with colonoscopy(combined group),102 cases underwent laparoscopic treatment(endoscopic group).The clinical data of the two groups were comparable.The number of times of operation,the time of operation,the recovery time of gastrointestinal function,the number of hospital stay,the average margin,the average number of lymph node dissection,the number of secondary operations(including intraoperative treatment of anastomosis,intraoperative surgery)(Anastomosis such as bleeding,leakage and cardiopulmonary complications),follow-up after discharge,etc.,to explore the laparoscopic surgery combined with colonoscopy in the treatment of colorectal cancer safety and effectiveness.Results: There was no significant difference between the two groups in operation and intraoperative bleeding(t= 2.518,1.94,P = 0.057,0.077,respectively).There were 10 cases of anastomosis in the combined group,and 7cases were not satisfied with the anastomosis.There were 3 cases of hemorrhage and 4 cases(all of them were hemorrhage).The difference was statistically significant(χ2 = 4.218,P = 0.040).There were statistically significant differences(χ2 = 7.789,P = 0.005)in the combined group(n = 9)and the combined group.There were no significant differences in anal exhaust,defecation time,eating time and postoperative hospital stay for the first time(t= 1.482,1.726,1.653,2.451,P= 0.327,0.518,0.483,0.752,respectively)The Anastomotic complications: combined group of anastomotic leakage in 2 cases(2.38%),were conservative cure;cavity group anastomotic leakage in 7 cases,bleeding in 3 cases,a total of 10 cases(9.80%),of which 4 cases were cured by2(χ2= 4.205,P= 0.040).Conclusion: There is no significant difference between the two groups(χ2 = 4.205,P = 0.040).There were 12 cases of postoperativeinfection(2 cases of abdominal infection,5 cases of incision infection,2 cases of pulmonary infection and 3 cases of urinary tract infection),13 cases of endoscopic group(2 cases of abdominal infection,4 cases of incision infection,3 cases,4 cases of urinary tract infection)were not statistically significant(χ2 =0.094,P = 0.759).There were no significant differences in the length of the colon specimens,the length of the rectal specimens,the length of the distal circumference of the colon,the length of the distal rectum and the number of lymph nodes in the two groups(t= 2.615,1.476,0.453,1.45,0.912,P =0.072,0.135,0.604,0.215,0.367).There was no significant difference between the two groups(χ2 = 2.421,P= 0.120).Conclusion: 1.Laparoscopic surgery in the treatment of colorectal cancer is safe and feasible.2.Laparoscopic combined with intraoperative colonoscopy can be three-dimensional observation of the lesion,the two complementary advantages,to achieve "accurate" surgical resection,to maximize the advantages of minimally invasive treatment,but also better reflect the "principle of radical cancer".