Clinical Control Study on Effects of Postoperative Clinical Rehabilitation Index and Humoral Immune of Laparoscopic Resection for Liver Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 NIU Jian ¹ , WANG Haijun ¹ , SHAO Hua ² , WANG Yue ¹ , ZHANG Yewei ³ , LIU Bin. ¹

1. General Surgery of The First Hospital Affiliated Xuzhou Medical College， Xuzhou 221004， Jiangsu Province， China;;
2. General Surgery of The Second Hospital Affiliated Nanjing University of Chinese Medicine， Nanjing 220046， Jiangsu Province， China;;
3. General Surgery of Jiangsu Tumour Hospital， Nanjing 210000， Jiangsu Province， China;

Corresponding author：

NIU Jian, Email: njnj_001@163.com

Keywords：

Liver cancer; Laparoscope; Resection; Humoral immune

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Objective 　To investigate the impact of laparoscopic versus. open hepatic resection for liver cancer on clinical rehabilitation and humoral immune function in patients organism.
Methods 　Forty-four patients of laparoscopic and open left-lateral sectionectomy from January 2010 to June 2012 were selected， including 22 patients of laparoscopy group and 22 patients of conventional laparotomy group. The levels of IgG， IgA， IgM， C3， C4， C reactive protein （CRP）， IL-2， IL-6， and TNF-α in peripheral blood of patients on the last day before operation， first day and 5th day after operation were determinated by using ELISA assay. At the same time， the operative time， intraoperative bleeding， hospitalization time， and complications after operation between two groups were compared.
Results 　The postoperative analgesic using time， first time eating， and hospitalization time in laparoscopic group were （1.9±0.8） days，（2.2±0.5） days， and （6.3±1.3） days， respectively， they were shorter than that in conventional laparotomy group （P＜0.05）. The operative time， intraoperative bleeding， complication rate， and mortality in two groups were not significant differences（P＞0.05） . Compared with before operation， the levels of C3， C4， IgA， IgG， IgM， and IL-2 on the first day after oper-ation in two groups were obviusly reduced， the levels of CRP， IL-6， and TNF-α on the first day after operation in two groups were significantly increased. The levels of C3， C4， lgA， IgG， lgM， and IL-2 on the first day after operation in conventional laparotomy group were significantly decreased than that in laparoscopic group （P＜0.05）. On the 5th day after operation， the levels of C3， C4， lgA， IgG， lgM， and IL-2 of laparoscopy group increased， the levels of CRP， IL-6，and TNF-α were reduced，that were no difference compared with before operation. Compared with before operation，the levels of C3， C4， lgA， IgG， lgM， and IL-2 of conventional laparotomy group were still at a low level state， and the levels of CRP， IL-6， and TNF-α were still at a high level state on the 5th day after operation.
Conclusions 　Laparoscopic resection of liver cancer after operation， the patients’ recovery are quickly， and the impact on humoral immune function of laparoscopic radical resection for liver cancer patients is significantly less than that conventional laparotomy.

Citation： NIU Jian,WANG Haijun,SHAO Hua,WANG Yue,ZHANG Yewei,LIU Bin.. Clinical Control Study on Effects of Postoperative Clinical Rehabilitation Index and Humoral Immune of Laparoscopic Resection for Liver Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(4): 356-361. doi: Copy

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19.	Battaglia A， Buzzonetti A， Baranello C， et al. IL-21 synergises with IL-2 to enhance TCR-induced human T cell proliferation and counteracts IL-2/TGF-β-induced regulatory T cell development[J]. Immunology， 2012 Dec 26. [Epub ahead of print].
20.	Ziekman PG， Otter WD， Tan JF， et al. Intratumoural interleukin-2 therapy can induce regression of non-resectable mastocytoma in dogs[J]. Anticancer Res， 2013， 33(1)：161-165.
21.	Lee S， Margolin K. Tumor-infiltrating lymphocytes in melanoma[J]. Curr Oncol Rep， 2012， 14(5)：468-474.
22.	Younis S， Rosner I， Rimar D， et al. Weight change during pharmacological blockade of interleukin-6 or tumor necrosis factor-α in patients with inflammatory rheumatic disorders：A 16-week comparative study[J]. Cytokine， 2013， 61(2)：353-355.
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26.	Maria TG， Vasileios KE， Panagiotis PS， et al. Changes of acute-phase protein levels in the serum of lung cancer patients following radiotherapy[J]. Int J Clin Exp Med， 2013，6(1)：50-56.
27.	Douraiswami B， Dilip PK， Harish BN， et al. C-reactive protein and interleukin-6 levels in the early detection of infection after open fractures[J]. J Orthop Surg (Hong Kong)， 2012， 20(3)：381-385.

1. Winslow E， Hawkins WG. Laparoscopic resection of the liver for cancer[J]. 　Surg Oncol Clin N Am， 2013，22(1)：75-89.
2. 陈小勋，黄顺荣，林源，等. 腹腔镜与开腹手术治疗肝癌的临床对比[J]. 中华普通外科杂志，2010，25(9)：729-733.
3. Dindo D， Demartines N， Clavien PA. Classification of surgicalcomplications：a new proposal with evaluation in a cohort of 6 336patients and results of a survey[J]. Ann Surg， 2004， 240(2)：205-213.
4. Mostaedi R， Milosevic Z， Han HS， et al. Laparoscopic liver resection：Current role and limitations[J]. World J Gastrointest Oncol， 2012，4(8)：187-192.
5. 杨学伟，曹良启，蒋小峰，等. 腹腹腔镜与开腹肝切除术治疗肝癌的疗效对比[J]. 中华普通外科杂志， 2012， 27(2)：100-102.
6. 黄建钊，石承先，苟欣，等. 腹腔镜肝叶切除25例报道[J]. 中国普外基础和临床杂志， 2011， 18(3)：324-326.
7. 郑树国，李建伟，陈健，等. 腹腔镜手术治疗肝癌128例的疗效评析[J]. 中华消化外科杂志， 2010，9(1)：35-37.
8. Kluger MD， Cherqui D. Laparoscopic resection of hepatocellular carcinoma[J]. Recent Results Cancer Res， 2013，190：111-126.
9. Veenhof AA， Vlug MS， van der Pas MH， et al. Surgical stress response and postoperative immune function after laparoscopy or open surgery with fast track or standard perioperative care：a randomized trial[J]. Ann Surg， 2012， 255(2)：216-221.
10. Vlug MS， Wind J， van der Zaag E， et al. Systematic review of laparoscopic vs open colonic surgery within an enhanced recovery programme[J]. Colorectal Dis， 2009，11(4)：335-343.
11. Koerner P， Westerholt A， Kessler W， et al. Surgical trauma and postoperative immunosuppression[J]. Chirurg， 2008， 79(4)：290-294.
12. Menges P， Kessler W， Kloecker C， et al. Surgical trauma and postoperative immune dysfunction[J]. Eur Surg Res， 2012， 48(4)：180-186.
13. Kimura F， Shimizu H， Yoshidome H， et al. Immunosuppression following surgical and traumatic injury[J]. Surg Today， 2010， 40(9)：793-808.
14. Yehudai D， Vadasz Z. IgM enriched immunoglobulins as a therapyfor sepsis and autoimmune diseases[J]. Harefuah， 2012， 151 (3)：171-174.
15. Jayne DG， Thorpe HC， Copeland J， et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancerl[J]. Br J Surg， 2010， 97(11)：1638-1645.
16. Kuhry E， Schwenk WF， Gaupset R， et al. Long-term results of laparoscopic colorectal cancer resection[J]. Cochrane Database Syst Rev， 2008， 16 (2)：CD003432.
17. Martel G， Duhaime S， Barkun JS， et al. The quality of research synthesis in surgery：the case of laparoscopic surgery for colorectalcancer[J]. Syst Rev， 2012，1(1)：14.
18. Mazzoccoli G， Sothern RB， Francavilla M， et al. Hormone and cytokine circadian alteration in non-small cell lung cancer patients[J]. Int J Immunopathol Pharmacol， 2012，25(3)：691-702.
19. Battaglia A， Buzzonetti A， Baranello C， et al. IL-21 synergises with IL-2 to enhance TCR-induced human T cell proliferation and counteracts IL-2/TGF-β-induced regulatory T cell development[J]. Immunology， 2012 Dec 26. [Epub ahead of print].
20. Ziekman PG， Otter WD， Tan JF， et al. Intratumoural interleukin-2 therapy can induce regression of non-resectable mastocytoma in dogs[J]. Anticancer Res， 2013， 33(1)：161-165.
21. Lee S， Margolin K. Tumor-infiltrating lymphocytes in melanoma[J]. Curr Oncol Rep， 2012， 14(5)：468-474.
22. Younis S， Rosner I， Rimar D， et al. Weight change during pharmacological blockade of interleukin-6 or tumor necrosis factor-α in patients with inflammatory rheumatic disorders：A 16-week comparative study[J]. Cytokine， 2013， 61(2)：353-355.
23. Takagi H， Mizuno Y， Yamamoto H， et al. Effects of telmisartan therapy on interleukin-6 and tumor necrosis factor-alpha levels：a meta-analysis of randomized controlled trials[J]. Hypertens Res， 2012 Dec 13. [Epub ahead of print].
24. Parkitny L， McAuley JH， Di Pietro F， et al. Inflammation in complex regional pain syndrome：A systematic review and meta-analysis[J]. Neurology， 2013，80(1)：106-117.
25. Lima-Junior Jda C， Rodrigues-da-Silva RN， Pereira VA， et al. Cells and mediators of inflammation (C-reactive protein， nitric oxide， platelets and neutrophils) in the acute and convalescent phases of uncomplicated Plasmodium vivax and Plasmodium falciparum infection [J]. Mem Inst Oswaldo Cruz， 2012，107(8)：1035-1041.
26. Maria TG， Vasileios KE， Panagiotis PS， et al. Changes of acute-phase protein levels in the serum of lung cancer patients following radiotherapy[J]. Int J Clin Exp Med， 2013，6(1)：50-56.
27. Douraiswami B， Dilip PK， Harish BN， et al. C-reactive protein and interleukin-6 levels in the early detection of infection after open fractures[J]. J Orthop Surg (Hong Kong)， 2012， 20(3)：381-385.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Control Study on Effects of Postoperative Clinical Rehabilitation Index and Humoral Immune of Laparoscopic Resection for Liver Cancer

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