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.
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.
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8.	Nishi K, Tokunaga A, Shimiznu Y, et al. Immunohistochemmcal stugy of intracellular estrodiol in human gastric cancer[J]. Cancer, 2001, 59:1328.
9.	吳秀萍, 吳雄, 楊樂藝, 等. 超聲刀在乳腺癌腋窩淋巴結清掃中的應用價值[J]. 中華內分泌外科雜志, 2013, 10(7):409-410.
10.	楊曉平, 卜建國, 蔡秀軍. 腹腔鏡膽囊切除術的手術時間對機體應激反應的影響[J]. 中國微創外科雜志, 2007, 7(9):912-914.
11.	吳文學. 腹腔鏡膽囊切除術對機體急性創傷炎癥應激反應的影響研究[J]. 中國全科醫學, 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.	儲怡星, 張錦鋒, 范基農, 等. C反應蛋白水平對判斷炎癥和創傷轉歸的價值[J]. 上海醫學檢驗雜志, 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, 劉小衛, 黎欣. 超聲刀與電刀在腹腔鏡膽囊切除術中療效對比分析[J]. 內蒙古中醫藥, 2014, 33(26):70-封3.
16.	方軍, 姜慧芳, 付霜. 麻醉與手術對乳腺癌患者圍手術期免疫功能的影響[J]. 腫瘤學雜志, 2009, 15(5):429-431.
17.	秦青平. 超聲刀在胃腸外科手術中的臨床應用分析[J]. 現代診斷與治療, 2014, 25(4):813.

1. 李振軍, 應曉江, 陳洪亮, 等. 腹腔鏡直腸癌ISR和Miles術后患者生活質量對比研究[J]. 中華腔鏡外科雜志:電子版, 2014, 7(2):111-115.
2. 何威, 鄧海軍, 余江, 等. 腹腔鏡與開腹直腸癌根治術對機體C反應蛋白及體液免疫影響的比較[J]. 中華胃腸外科雜志, 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. 李正榮, 揭志剛, 劉逸, 等. 新型超聲刀在胃癌根治術中的應用[J/CD]. 中華普通外科學文獻:電子版, 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, 祖國, 王忠裕. 低位直腸癌保肛手術的治療進展[J]. 大連醫科大學學報, 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. 吳秀萍, 吳雄, 楊樂藝, 等. 超聲刀在乳腺癌腋窩淋巴結清掃中的應用價值[J]. 中華內分泌外科雜志, 2013, 10(7):409-410.
10. 楊曉平, 卜建國, 蔡秀軍. 腹腔鏡膽囊切除術的手術時間對機體應激反應的影響[J]. 中國微創外科雜志, 2007, 7(9):912-914.
11. 吳文學. 腹腔鏡膽囊切除術對機體急性創傷炎癥應激反應的影響研究[J]. 中國全科醫學, 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. 儲怡星, 張錦鋒, 范基農, 等. C反應蛋白水平對判斷炎癥和創傷轉歸的價值[J]. 上海醫學檢驗雜志, 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, 劉小衛, 黎欣. 超聲刀與電刀在腹腔鏡膽囊切除術中療效對比分析[J]. 內蒙古中醫藥, 2014, 33(26):70-封3.
16. 方軍, 姜慧芳, 付霜. 麻醉與手術對乳腺癌患者圍手術期免疫功能的影響[J]. 腫瘤學雜志, 2009, 15(5):429-431.
17. 秦青平. 超聲刀在胃腸外科手術中的臨床應用分析[J]. 現代診斷與治療, 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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