ABSTRACT
Objective To compare the advantages and disadvantages of two approaches of laparoscopic radical resection for right colon cancer.Methods The data of 41 patients with right colon cancer in our hospital from March 2015 to December 2016 were analyzed retrospectively,who were randomly divided into the caudal-to-cranial group(n=23) and classical medial-to-lateral group(n=18) according to different approaches.The operation time,intraoperative blood loss,conversion rate,the number of lymph nodes dissection,hospital stay time and postoperative complications between two groups were compared.Results The operation time,intraoperative blood loss,the conversion rate of the caudal-to-cranial group were better than those of the classical medial-to-lateral group,the differences were significant(P<0.05).There was no significant difference in hospital stay time,the number of lymph nodes dissection and postoperative complications between two groups.Conclusion Laparoscopic radical resection for right colon cancer by caudal-to-cranial approach is easy to operate and dissect,it can shorten the operation time,decrease the intraoperative blood loss,which is worthy of clinical promotion.
ABSTRACT
Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .
