Minimally invasive surgery vs laparotomy in patients with colon cancer residing in high-altitude areas

Abstract

BACKGROUND Colon cancer is associated with a higher incidence among residents in high-altitude areas. Hypoxic environment at high altitudes inhibits the phagocytic and oxygen-dependent killing function of phagocytes, thereby increasing the inflammatory factors, inhibiting the body’s innate immunity and increasing the risk of colon cancer. AIM To examine the effect of minimally invasive surgery vs laparotomy in patients with colon cancer residing in high-altitude areas. METHODS Ninety-two patients with colon cancer in our hospital from January 2019 to February 2021 were selected and divided into the minimally invasive surgery and laparotomy groups using the random number table method, with 46 patients in each group. Minimally invasive surgery was performed in the minimally invasive group and laparotomy in the laparotomy group. Operative conditions, inflammatory index pre- and post-surgery, immune function index and complication probability were measured. RESULTS Operative duration was significantly longer and intraoperative blood loss and recovery time of gastrointestinal function were significantly less (all P < 0.05) in the minimally invasive group than in the laparotomy group. The number of lymph nodes dissected was not significantly different. Before surgery, there were no significant differences in serum C-reactive protein, interleukin-6 and tumor necrosis factor-α levels between the groups, whereas after surgery, the levels were significantly higher in the minimally invasive group (26.98 ± 6.91 mg/L, 146.38 ± 11.23 ng/mL and 83.51 ± 8.69 pg/mL vs 41.15 ± 8.39 mg/L, 186.79 ± 15.36 ng/mL and 110.65 ± 12.84 pg/mL, respectively, P < 0.05). Furthermore, before surgery, there were no significant differences in CD3+, CD4+ and CD4+/CD8+ levels between the groups, whereas after surgery, the levels decreased in both groups, being significantly higher in the minimally invasive group (55.61% ± 4.39%, 35.45% ± 3.67% and 1.30 ± 0.35 vs 49.68% ± 5.33%, 31.21% ± 3.25% and 1.13 ± 0.30, respectively, P < 0.05). Complication probability was significantly lower in the minimally invasive group (4.35% vs 17.39%, P < 0.05). CONCLUSION Laparoscopic minimally invasive procedures reduce surgical trauma and alleviate the inflammatory response and immune dysfunction caused by invasive operation. It also shortens recovery time and reduces complication probability.