The Perioperative Comparative Evolution of Surgical Stress Markers in Colorectal Cancer Patients Between Classical and Laparoscopic Surgery

Abstract Multiple biological parameters were proposed to evaluate the surgical stress response in the early postoperative period. Granulocyte/lymphocyte (G/L) ratio may be a useful marker and widely available. Measuring some of known surgical stress related markers together with G/L ratio we tried to confirm the superiority of laparoscopic approach and efficiency of the G/L ratio monitoring in this period. Materials and methods: 52 colorectal cancer patients who underwent elective surgery in a private clinical hospital were evaluated preoperatively and postoperatively (day 1 and day 5) for the: TNF-α, cortisol, C reactive protein (CRP) and G/L ratio. Results: Only CRP levels were significantly lower in the laparoscopy group in day 1 (74.07 vs 50.32, p=0.0461) and day 5 (18.37 vs 7.32, p=0.0001). The G/L ratio showed strong correlation with CRP levels in all measurements. Conclusions: Measurement of postoperative CRP levels confirmed the reduced surgical stress of laparoscopic colectomy for colorectal cancer in our clinic.