Effect of laparoscopic radical resection of colorectal cancer through natural cavity on postoperative pain, inflammatory response, and intestinal barrier function in patients and health and economics evaluation
XIE Wei WANG Xiangzhong ZHAO Ke CUI Suyang LI Fei
Department of General Surgery, Jurong People Hospital, Jiangsu Province, Jurong 212400, China
Abstract：Objective To evaluate the effects of trans-anal nature orifice specimen extraction (ta-NOSE) on postoperative pain, inflammatory response and intestinal barrier function in patients and health and economics. Methods Sixty patients underwent laparoscopic colorectal resection (LCR) in Jurong People Hospital, Jiangsu Province from June 2018 to March 2021 were selected, they were divided into two groups by random number table method, with 30 cases in each group. LCR group was treated with routine LCR, and ta-NOSE group was treated with ta-NOSE after LCR. The operation related indexes, pain, inflammation, intestinal barrier function indexes, complications, and health economic evaluation were compared between two groups. Results The amount of intraoperative bleeding in ta-NOSE group was less than that in LCR group, and the postoperative exhaust time and postoperative hospital stay in ta-NOSE group were shorter than those in LCR group (P < 0.05). At three days after operation, visual analogue scale (VAS) scores of two groups were higher than those at one day after operation (P < 0.05). At one day and three days after operation, VAS scores of ta-NOSE group was lower than those of LCR group (P < 0.05). There were statistically significant differences in serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), plasma D-lactic acid, and diamine oxidase (DAO) between two groups at different time points (P < 0.05). At one day and three days after operation, serum CRP and TNF-α, plasma D-lactic acid, and DAO between two groups were compared, and the differences were statistically significant (P < 0.05). There was no significant difference in total incidence of complication between two groups (P > 0.05). There was no significant difference in direct medical cost between two groups (P > 0.05); and the direct non-medical cost, indirect medical cost, and total cost in ta-NOSE group were lower than those in LCR group (P < 0.05). Conclusion Compared with conventional LCR, ta-NOSE in patients with colorectal cancer has less trauma, faster postoperative recovery, less stress and inflammation, and higher health and economic value.
谢伟 汪想忠 赵柯 崔苏阳 李飞. 经自然腔道腹腔镜结直肠癌根治术对患者术后疼痛、炎症反应、肠道屏障功能影响及卫生经济学评价[J]. 中国医药导报, 2022, 19(20): 96-99.
XIE Wei WANG Xiangzhong ZHAO Ke CUI Suyang LI Fei. Effect of laparoscopic radical resection of colorectal cancer through natural cavity on postoperative pain, inflammatory response, and intestinal barrier function in patients and health and economics evaluation. 中国医药导报, 2022, 19(20): 96-99.
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