Impacts of Ultracision <i>versus</i> Electrotome on Immune Function and Stress Reaction in Patients after Rectal Cancer Miles Operation_West China Medical Journal

Authors：

 JIAOGui-liang , JIANGZhi-long ,  ZHOUBin , LUJin-liang , JITao , XUJian-feng , JIChang-hui , CHENGZhi-rong , GENGZhong-ze , ChangLai

Department of Genery Surgery, Taixing Hospital Affiliated to Yangzhou University, Taixing, Jiangsu 225400, P. R. China;

Corresponding author：

ZHOUBin, Email: zhbinvv@163.com

Keywords：

Rectal cancer; Immune active stress; Ultracision; Electrotome

DOI：

10.7507/1002-0179.20150642

Video：

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Objective To discuss the influence of ultracision versus electrotome on the immune function and stress reaction in patients after rectal cancer Miles operation. Method A retrospective analysis was performed on 82 rectal cancer patients who received Miles operation between February 2007 and August 2012. Among them, 45 accepted ultracision, and 37 received electrotome operation. We compared the two groups in terms of abdominal and perineum surgery time, blood loss volume, drainage volume within 72 hours after operation, and analyzed the CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ ratio by flow cytometry before and after operation. In addition, we tested the white blood cell count, percentage of granulocyte, C-reaction protein (CRP), and interleukin (IL)-6 three days after operation. Results There was no obvious difference in CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺ ratio between the two groups. However, the incidence of blood loss volume, abdominal operation time, perineum operation time, drainage volume within 72 hours after operation, white blood cell count, percentage of granulocyte, CRP, IL-6 in the ultracision group was dramatically lower compared with the electrotome group (P<0.05). Conclusions There is no significant difference in the influence on the immune function between the two kinds of operation methods, but ultracision can achieve faster recovery and smaller stress reaction after operation. It is worthy of clinical popularization.

Citation： JIAOGui-liang, JIANGZhi-long, ZHOUBin, LUJin-liang, JITao, XUJian-feng, JIChang-hui, CHENGZhi-rong, GENGZhong-ze, ChangLai. Impacts of Ultracision versus Electrotome on Immune Function and Stress Reaction in Patients after Rectal Cancer Miles Operation. West China Medical Journal, 2015, 30(12): 2238-2241. doi: 10.7507/1002-0179.20150642 Copy

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5.	Lemmens V, Van Steenbergen L, Janssen-Heijnen M, et al. Trends in colorectal cancer in the South of the Netherlands 1975-2007:rectal cancer survival levels with colon cancer survival[J]. Acta Oncol, 2010, 49(6):784-796.
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9.	吴秀萍, 吴雄, 杨乐艺, 等. 超声刀在乳腺癌腋窝淋巴结清扫中的应用价值[J]. 中华内分泌外科杂志, 2013, 10(7):409-410.
10.	杨晓平, 卜建国, 蔡秀军. 腹腔镜胆囊切除术的手术时间对机体应激反应的影响[J]. 中国微创外科杂志, 2007, 7(9):912-914.
11.	吴文学. 腹腔镜胆囊切除术对机体急性创伤炎症应激反应的影响研究[J]. 中国全科医学, 2010, 12(15):1639-1641.
12.	Phang PG. Effects of change in rectal cancer management on outcomes in British Columbia[J]. Can J Surg, 2010, 53(4):225-231.
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14.	Herman MP, Kopetz S, Bhosale PR, et al. Sacral insufficiency fractures after preoperative chemoradiation for rectal cancer:incidence, risk factors, and clinical course[J]. Int J Radiat Oncol Biol Phys, 2009, 74(3):818-823.
15.	沈一松, 刘小卫, 黎欣. 超声刀与电刀在腹腔镜胆囊切除术中疗效对比分析[J]. 内蒙古中医药, 2014, 33(26):70-封3.
16.	方军, 姜慧芳, 付霜. 麻醉与手术对乳腺癌患者围手术期免疫功能的影响[J]. 肿瘤学杂志, 2009, 15(5):429-431.
17.	秦青平. 超声刀在胃肠外科手术中的临床应用分析[J]. 现代诊断与治疗, 2014, 25(4):813.

1. 李振军, 应晓江, 陈洪亮, 等. 腹腔镜直肠癌ISR和Miles术后患者生活质量对比研究[J]. 中华腔镜外科杂志:电子版, 2014, 7(2):111-115.
2. 何威, 邓海军, 余江, 等. 腹腔镜与开腹直肠癌根治术对机体C反应蛋白及体液免疫影响的比较[J]. 中华胃肠外科杂志, 2009, 12(4):357-360.
3. Zhou BJ, Song WQ, Yan QH, et al. Ultrasonically activated scalpel versus monopolar electrocautery shovel in laparoscopic total mesorectal excision for rectal cancer[J]. World J Gastroenterol, 2008, 14(25):4065-4069.
4. 李正荣, 揭志刚, 刘逸, 等. 新型超声刀在胃癌根治术中的应用[J/CD]. 中华普通外科学文献:电子版, 2009, 3(6):510-512.
5. Lemmens V, Van Steenbergen L, Janssen-Heijnen M, et al. Trends in colorectal cancer in the South of the Netherlands 1975-2007:rectal cancer survival levels with colon cancer survival[J]. Acta Oncol, 2010, 49(6):784-796.
6. Corral L, Carrió ML, Ventura JL, et al. Is C-reactive protein a biomarker for immediate clinical outcome after cardiac surgery?[J]. J Cardiothorac Vasc Anesth, 2009, 23(2):166-169.
7. 郭京, 祖国, 王忠裕. 低位直肠癌保肛手术的治疗进展[J]. 大连医科大学学报, 2010, 32(6):724-727.
8. Nishi K, Tokunaga A, Shimiznu Y, et al. Immunohistochemmcal stugy of intracellular estrodiol in human gastric cancer[J]. Cancer, 2001, 59:1328.
9. 吴秀萍, 吴雄, 杨乐艺, 等. 超声刀在乳腺癌腋窝淋巴结清扫中的应用价值[J]. 中华内分泌外科杂志, 2013, 10(7):409-410.
10. 杨晓平, 卜建国, 蔡秀军. 腹腔镜胆囊切除术的手术时间对机体应激反应的影响[J]. 中国微创外科杂志, 2007, 7(9):912-914.
11. 吴文学. 腹腔镜胆囊切除术对机体急性创伤炎症应激反应的影响研究[J]. 中国全科医学, 2010, 12(15):1639-1641.
12. Phang PG. Effects of change in rectal cancer management on outcomes in British Columbia[J]. Can J Surg, 2010, 53(4):225-231.
13. 储怡星, 张锦锋, 范基农, 等. C反应蛋白水平对判断炎症和创伤转归的价值[J]. 上海医学检验杂志, 2000, 15(3):155-156.
14. Herman MP, Kopetz S, Bhosale PR, et al. Sacral insufficiency fractures after preoperative chemoradiation for rectal cancer:incidence, risk factors, and clinical course[J]. Int J Radiat Oncol Biol Phys, 2009, 74(3):818-823.
15. 沈一松, 刘小卫, 黎欣. 超声刀与电刀在腹腔镜胆囊切除术中疗效对比分析[J]. 内蒙古中医药, 2014, 33(26):70-封3.
16. 方军, 姜慧芳, 付霜. 麻醉与手术对乳腺癌患者围手术期免疫功能的影响[J]. 肿瘤学杂志, 2009, 15(5):429-431.
17. 秦青平. 超声刀在胃肠外科手术中的临床应用分析[J]. 现代诊断与治疗, 2014, 25(4):813.

West China Medical Journal

Impacts of Ultracision versus Electrotome on Immune Function and Stress Reaction in Patients after Rectal Cancer Miles Operation

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