外科ジャーナル

To Investigate the Impact of Laparoscopic Resection of Colorectal Carcinoma on the Peritoneal Metastases of Cancer

Abstract

Xin Wang, Anren Sun, Linkang Xiao and Rong Yang

Objective: To explore the effect of laparoscopy on cancer cells and the expressions of adhesion molecules (ICAM‐1, CD44v6 & integrin β1) in peritoneal tissue and abdominal rinse in patients with colorectal carcinoma (CC).

Methods: A total of 65 CC cases undergoing radical resection at our hospital were analyzed. They were divided into two groups of LAP (laparoscopy, n=35) and OP (open surgery, n=30). Peritoneal tissues were collected at incision and beyond .Also abdominal rinse was collected before tumor resection and abdomen closure. The expressions of adhesion molecules (ICAM‐1 ,CD44v6 & integrin beta 1) in peritoneal and abdominal cavities of two groups were detected by immunohistochemistry and double‐antibody sandwich ABC‐ELISA. And cancer cells in abdominal rinse were detected by peritoneal lavage cytology (PLC) for comparing two surgical methods.

Results: In LAP group, PLC was positive in 3 cases (8.6%) before tumor resection and 8 cases (22.9%) before abdominal closure. In OP group, PLC was positive in 4 cases (13.3%) before tumor resection and 8 cases (26.7% ) before abdominal closure. No inter‐group difference existed in PLC (P>0.05). The expressions of CD44v6, ICAM‐1 and integrin beta 1 in abdominal cavity (before tumor resection & abdomen closure) were compared for LAP and OP groups. And there was no statistically significant difference ( P>0 05). The expressions of CD44v6 ,ICAM‐1 and integrin beta 1 in peritoneal tissues (at incision and beyond) were compared between LAP and OP groups .And there was no statistically significant difference (P>0.05).

Conclusion: Compared with CC patients undergoing traditional open surgery, the risk of exfoliated cancer cells in abdominal cavity shows no increase. And there is no impact `upon the expressions of adhesion molecules.