Effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation: report of 190 cases

To investigate the effect of different periods of laparoscopic radical resection for colorectal cancer on rehabilitation in patients.

A retrospective cohort study was conducted on 190 patients who accepted laparoscopic radical resection of colorectal cancer in our hospital from October 2020 to September 2021. The patients were divided into 2 groups according to the starting time of the operation: the morning（8:00~12:00）operation group（n=98）and the afternoon（14:00~18:00）operation group（n=92）. The indicators were compared between 2 groups, including the duration of operation and anesthesia, the time of extubation, the volume of intraoperative blood loss, the first time of food intake, the first anal exhaust time, the first defecation time, preoperative and postoperative immune peripheral blood cells count, postoperative immune-inflammation indexes, the incidence of complications, length of stay and costs.

The afternoon surgery group had increased patients without complications and earlier first time of food intake of patients, compared with the morning surgery group（P=0.023, P=0.012）. After the surgery, white blood cell（WBC）and neutrophil（Neu）counts in the afternoon surgery group significantly increased, while lymphocytes（Lym）significantly decreased（P<0.01）. Neutrophil to lymphocytes ratio（NLR）, platelet to lymphocytes ratio（PLR）and systemic immune inflammation index（SII）in the afternoon surgery group were significantly higher than those in the morning surgery group（P<0.001）. There was no significant difference in length of stay and cost（P>0.05）.

The patients undergoing laparoscopic radical resection for colorectal cancer in the afternoon have fewer complications, earlier first time of food intake and better short-term rehabilitation.