Analysis of the feasibility,safety and effectiveness of radical cure in laparoscopic radical resection of rectal carcinoma

Objective:To evaluate the feasibility,safety and effectiveness of radical cure in laparoscopic radical resection of rectal carcinoma. Methods:Fifty-four cases of laparoscopic radical resection of rectal carcinoma from Feb. 2008 to Feb. 2013 were randomly selected as the laparoscopic group. Sixty cases of traditional open surgery for rectal carcinoma were selected as the open group(control group). The general information,mean operation time,intraoperative blood loss,intraoperative blood transfusion,postoperative complications,recovery,changes of the preoperative and postoperative levels of inflammatory response,immune function,tumor markers and effectiveness of radical cure between the 2 groups were compared. Results:Laparoscopic surgery and open surgery were both successful in all 114 cases. No patients were converted to laparotomy in the laparoscopic group. No significant difference was found in the general information of patients(P 0. 05). The mean operation time in the laparoscopic group was significantly longer than that of the open group(t = 5. 124,P 0. 05). The mean intraoperative blood loss in laparoscopic group was less than the open group(t = 8. 108,P = 0. 000). No significant difference was found in blood transfusion rates of both groups(P 0. 05). Postoperative recovery situation in the laparoscopic group was better than the open group(P 0. 05). The preoperative levels of CRP,CD4+,CD8+,CD4+/CD8+ratio in both groups were not significantly different( P 0. 05). On the 3rd,7th,10 th day after surgery,the postoperative levels of CRP,CD8+in the laparoscopic group were lower than the open group(P 0. 05);the levels of CD4+,CD4+/CD8+ratio in the laparoscopic group were higher than the open group(P 0. 05). The preoperative and postoperative levels and positive rate of CA242,CEA,CA724,CA199 of two groups were not significantly different(P 0. 05). The overall complication rate was 13% in the laparoscopic group and23. 3% in the open group without significant difference(P 0. 05). No significant difference was observed in specimen length,number of lymph nodes cleaned,rate and degree of lymph nodes metastasis between two groups(P 0. 05). Conclusions:Laparoscopic radical resection of rectal carcinoma is a feasible,safe,minimally invasive technique which provides better short-term outcomes,fewer complications,shorter postoperative hospital stay and similar oncological outcomes compared with the traditional open procedure. Laparoscopic radical resection of rectal carcinoma could be the best choice for rectal carcinoma.