Nakagoe T, Tsuji T, Sawai T, Sugawara K, Inokuchi N, Kamihira S, Arisawa K
First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan.
Eur Surg Res. 2003 Nov-Dec;35(6):477-85. doi: 10.1159/000073386.
A minilaparotomy approach (skin incision less than 7 cm) to resection of colon cancer is technically feasible, but objective data supporting its benefit are scarce. The aim of this study was to clarify whether minilaparotomy is independently associated with a reduction in the acute inflammatory response after resection of colorectal cancer.
Thirty-one patients who underwent surgical resection of colorectal cancer using minilaparotomy or conventional laparotomy were included in this nonrandomized prospective study. Inflammatory responses were evaluated with serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels.
In both the minilaparotomy and conventional laparotomy groups, serum IL-6 and CRP levels significantly increased 24 h after the operation (1POD) compared to preoperative levels (p < 0.0001 and p < 0.0001, respectively). Median serum levels of IL-6 and CRP in the minilaparotomy group were significantly lower at 1POD versus the conventional group (p = 0.0066 and p = 0.0033, respectively). Multivariate analyses showed that a smaller increase in serum IL-6 or CRP levels at 1POD [less than 75th percentile (112.9 or 10.6 mg/ml, respectively)] was independently related to only minilaparotomy.
These data in this nonrandomized trial suggest that minilaparotomy may be independently associated with reduced inflammatory responses in colorectal cancer resection.
采用小切口剖腹术（皮肤切口小于7cm）切除结肠癌在技术上是可行的，但支持其益处的客观数据却很匮乏。本研究的目的是阐明小切口剖腹术是否与结直肠癌切除术后急性炎症反应的减轻独立相关。
本非随机前瞻性研究纳入了31例行小切口剖腹术或传统剖腹术切除结直肠癌的患者。通过血清白细胞介素-6（IL-6）和C反应蛋白（CRP）水平评估炎症反应。
与术前水平相比，小切口剖腹术组和传统剖腹术组术后24小时（术后第1天）血清IL-6和CRP水平均显著升高（分别为p<0.0001和p<0.0001）。小切口剖腹术组术后第1天IL-6和CRP的血清中位数水平显著低于传统组（分别为p=0.0066和p=0.0033）。多变量分析显示，术后第1天血清IL-6或CRP水平较小的升高[低于第75百分位数（分别为112.9或10.6mg/ml）]仅与小切口剖腹术独立相关。
这项非随机试验中的这些数据表明，小切口剖腹术可能与结直肠癌切除术中炎症反应减轻独立相关。
