Comparison of the efficacy of combined medial and caudal approach and cephalic medial-to-lateral approach in laparoscopic surgery for right hemicolon cancer with incomplete ileus / 中国医师进修杂志

ABSTRACT

Objective To compare the efficacy of laparoscopic surgery with combined medial and caudal approach and cephalic medial-to-lateral approach for right hemicolon cancer patients combined with incomplete ileus. Methods The clinical data of 98 right hemicolon cancer (T1- 4 M0) patients combined with incomplete ileus in Fukuang General Hospital of Liaoning Health Industry Group from January 2014 to December 2018 were retrospectively analyzed. All patients underwent laparoscopic right hemicolectomy, complete mesocolic excision (CME) and D3 lymphadenectomy. Among them, the combined medial and caudal approach was used in 50 patients (observation group), and the cephalic medial-to-lateral approach was used in 48 patients (control group). The operation time, bleeding volume, condition of lymph nodes dissected, length of hospital stay after operation and complication after operation were compared between 2 groups. Results Both groups successfully completed the operation, with no conversion to laparotomy and perioperative death. The bleeding volume and operation time in observation group were significantly lower than those in control group: (105.3 ± 22.6) ml vs. (309.6 ± 28.0) ml and (165.2 ± 17.9) min vs. (219.5 ± 21.5) min, and there were statistical differences (P﹤0.01 or ﹤0.05). There were no statistical differences in the number of lymph nodes dissected, proportion of lymph nodes dissected ≥ 12, number of positive lymph, length of hospital stay after operation and complication after operation between 2 groups (P＞0.05). Conclusions Laparoscopic surgery for right hemicolon cancer patients combined with incomplete ileus is safe and feasible. Compared with the cephalic medial-to-lateral approach, the combined medial and caudal approach can reduce the amount of intraoperative bleeding and shorten the operation time significantly.