Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1734-1741
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1734
Influence of reduced-port laparoscopic surgery on perioperative indicators, postoperative recovery, and serum inflammation in patients with colorectal carcinoma
Hong-Biao Wu, Dong-Fang Liu, Ye-Lei Liu, Xiao-Feng Wang, Yue-Peng Cao
Hong-Biao Wu, Dong-Fang Liu, Ye-Lei Liu, Xiao-Feng Wang, Yue-Peng Cao, Department of Colorectal Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang Province, China
Author contributions: Wu HB designed and performed the research and wrote the paper; Wu HB, Liu DF, Liu YL and Cao YP designed the research and supervised the report; Wu HB and Wang XF collected the data; Wu HB and Cao YP provided clinical advice and supervised the report.
Institutional review board statement: This study was approved by the Ethic Committee of The First Affiliated Hospital of Ningbo University.
Informed consent statement: This study was a retrospective study using anonymized data. The review board of The First Affiliated Hospital of Ningbo University approved the study and waived informed consent.
Conflict-of-interest statement: Dr. Cao has nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue-Peng Cao, MD, Chief Physician, Department of Colorectal Surgery, The First Affiliated Hospital of Ningbo University, No. 59 Liuting Street, Haishu District, Ningbo 315000, Zhejiang Province, China. 18368405604@163.com
Received: April 3, 2024
Revised: May 8, 2024
Accepted: May 11, 2024
Published online: June 27, 2024
Processing time: 87 Days and 17.4 Hours
Abstract
BACKGROUND

Conventional five-port laparoscopic surgery, the current standard treatment for colorectal carcinoma (CRC), has many disadvantages.

AIM

To assess the influence of reduced-port laparoscopic surgery (RPLS) on perioperative indicators, postoperative recovery, and serum inflammation indexes in patients with CRC.

METHODS

The study included 115 patients with CRC admitted between December 2019 and May 2023, 52 of whom underwent conventional five-port laparoscopic surgery (control group) and 63 of whom underwent RPLS (research group). Comparative analyses were performed on the following dimensions: Perioperative indicators [operation time (OT), incision length, intraoperative blood loss (IBL), and rate of conversion to laparotomy], postoperative recovery (first postoperative exhaust, bowel movement and oral food intake, and bowel sound recovery time), serum inflammation indexes [high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6)], postoperative complications (anastomotic leakage, incisional infection, bleeding, ileus), and therapeutic efficacy.

RESULTS

The two groups had comparable OTs and IBL volumes. However, the research group had a smaller incision length; lower rates of conversion to laparotomy and postoperative total complication; and shorter time of first postoperative exhaust, bowel movement, oral food intake, and bowel sound recovery; all of which were significant. Furthermore, hs-CRP, IL-6, and TNF-α levels in the research group were significantly lower than the baseline and those of the control group, and the total effective rate was higher.

CONCLUSION

RPLS exhibited significant therapeutic efficacy in CRC, resulting in a shorter incision length and a lower conversion rate to laparotomy, while also promoting postoperative recovery, effectively inhibiting the inflammatory response, and reducing the risk of postoperative complications.

Keywords: Reduced-port laparoscopic surgery, Colorectal carcinoma, Perioperative indicators, Postoperative recovery, Serum inflammation indexes

Core Tip: Colorectal carcinoma (CRC) is a fatal but preventable gastrointestinal malignancy, with surgical treatment being the standard of care. However, conventional laparoscopic surgery has obvious disadvantages. This study compared reduced-port laparoscopic surgery (RPLS) and conventional laparoscopic surgery and confirmed that the former had more advantages than the latter in CRC based on perioperative indicators, postoperative recovery, serum inflammatory responses, postoperative complications, and therapeutic efficacy. RPLS not only reduced the incision length and the rate of conversion to laparotomy but also promoted postoperative recovery, effectively inhibited the inflammatory response, and reduced the risk of postoperative complications.