The Perioperative Comparative Evolution of Surgical Stress Markers in Colorectal Cancer Patients Between Classical and Laparoscopic Surgery

Erika Bimbo-Szuhai, A. Maghiar, M. Botea, A. Huniadi, M. Șandor, Corina Beiușan, I. Macovei, Claudia Teodora Judea Pusta
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Abstract

Abstract Multiple biological parameters were proposed to evaluate the surgical stress response in the early postoperative period. Granulocyte/lymphocyte (G/L) ratio may be a useful marker and widely available. Measuring some of known surgical stress related markers together with G/L ratio we tried to confirm the superiority of laparoscopic approach and efficiency of the G/L ratio monitoring in this period. Materials and methods: 52 colorectal cancer patients who underwent elective surgery in a private clinical hospital were evaluated preoperatively and postoperatively (day 1 and day 5) for the: TNF-α, cortisol, C reactive protein (CRP) and G/L ratio. Results: Only CRP levels were significantly lower in the laparoscopy group in day 1 (74.07 vs 50.32, p=0.0461) and day 5 (18.37 vs 7.32, p=0.0001). The G/L ratio showed strong correlation with CRP levels in all measurements. Conclusions: Measurement of postoperative CRP levels confirmed the reduced surgical stress of laparoscopic colectomy for colorectal cancer in our clinic.
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结直肠癌经典手术与腹腔镜手术围手术期手术应激标志物的比较演变
摘要提出了多种生物学参数来评估术后早期的手术应激反应。粒细胞/淋巴细胞(G/L)比率可能是一个有用的标记,并且广泛可用。通过测量一些已知的手术应力相关标志物以及G/L比率,我们试图证实腹腔镜入路的优越性和该时期G/L比率监测的有效性。材料和方法:对52例在私立临床医院接受择期手术的癌症患者术前和术后(第1天和第5天)的TNF-α、皮质醇、C反应蛋白(CRP)和G/L比值进行评估。结果:腹腔镜组在第1天(74.07 vs 50.32,p=0.0461)和第5天(18.37 vs 7.32,p=0.0001)只有CRP水平显著降低。在所有测量中,G/L比与CRP水平呈强相关性。结论:术后CRP水平的测定证实了腹腔镜癌症结肠切除术减轻了手术压力。
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