Objective To investigate the effects of laparoscopic surgery based on colonoscopy combined with titanium clip in the treatment of colorectal cancer (CRC), and its effects on serum inflammatory factors, microRNAs and intestinal flora.
Methods A total of 100 CRC patients were randomly divided into two groups (50 cases each group). Both groups were treeated with laparoscopic radical CRC resection. The control group were treated with colonoscopy before operation, and the study group were trerated with colonoscopy combined with titanium clamp before operation. The preoperative tumor localization accuracy, operation and postoperative rehabilitation, serum inflammatory factorsprocalcitonin (PCT), mobility group protein B1(HMGB1) and interleukin-(IL-6), microRNAsMicroRNA (miR)-17, miR-20a and miR-92, intestinal flora (E. coli, coccibacillus and bifidobacterium), postoperative complications were compared betweentwo groups.
Resuts The accuracy rate of preoperative tumor localization in the study group (100.00%) was higher than that in control group (74.00%) (P ＜ 0.01). The operation time and intraoperative lesion exploration time in the study group were shorter than those in control group (P ＜ 0.05 and P ＜ 0.01). The serum levels of PCT, HMGB1 and IL-6 in the study group were lower than those in control group on postoperative day 3 and day 7 (P ＜ 0.01). There was no statistical significance in the levels of serum miR-17, miR-20a, and miR-92 between two groups on postoperative day 3 and day 7 (P ＞ 0.05), However, the serum levels of miR-17, miR-20a, and miR-92 in two groups were lower than those before surgery after 3d and 7d of surger (P ＜ 0.01). The number of Escherichia coli and Clostridium cocci in the study group was lower than that in control group during the first bowel movement after surgery, while the number of Bifidobacterium was higher than that in control group (P ＜ 0.01). The incidence of postoperative complications in the study group (4.00%) was lower than that in control group (16.00%) (P ＜ 0.05).
Conclusions Colonoscopy combined with titanium clip localization before laparoscopic surgery in CRC patients can significantly improve the accuracy of tumor localization, help to shorten the operation time and intraoperative lesion exploration time, reduce the influence on serum inflammatory factors and intestinal flora, reduce the postoperative levels of serum miR-17, miR-20a and miR-92, and reduce postoperative complications.
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