Clinical efficacy of three dividing lines in radical right hemicolectomy for right colon cancer / 中华消化外科杂志

ABSTRACT

Objective To investigate the clinical efficacy of three dividing lines in radical right hemicolectomy for right colon cancer.Methods The clinical data of 166 patients with right colon cancer (including ileocecal cancer,ascending colon carcinoma and hepatic flexure of the colon) who were admitted to the Affiliated Tumor Hospital of Zhengzhou University from March 2009 to August 2014 were retrospectively analyzed.Eightythree patients who underwent radical right hemicolectomy via three dividing lines were allocated to the modified group and 83 patients who underwent radical right hemicolectomy via medial approach were allocated to the control group.The operation time,volume of intraoperative blood loss,number of lymph node dissection and processing time and volume of the superior mesenteric vein (surgical trunk) hemorrhage were analyzed between the 2 groups.Patients were followed up by outpatient examination and telephone interview till November 2014.The measurement data with normal distribution were presented as x ± s.The comparison between groups was analyzed using t test.The count data were analyzed by the chi-square test.Results The operation time in the modified group and in the control group were (75 ± 7) minutes and (109 ± 13) minutes,respectively,with a significant difference (t =-36.700,P ＜0.05).The volume of intraoperative blood loss and number of lymph node dissection in the modified group were (118 ± 15)mL and 19 ±4,which were not significantly different from (116 ±22)mL and 18 ± 3 in the control group (t =0.104,12.300,P ＞ 0.05).During D3 lymph node dissection,the incidence of hemorrhage of the superior mesenteric vein,processing time of hemostasis and volume of blood loss were 3.6％ (3/83),(7 ± 3) minutes and (103 ± 25) mL in the modified group and 9.6％ (8/83),(20 ± 5) minutes and (209 ± 37)mL in the control group,respectively.There was no significant difference in the incidence of hemorrhage of the superior mesenteric vein between the 2 groups (x2 =2.434,P ＞ 0.05).There were significant differences in the processing time of hemostasis and volume of blood loss between the 2 groups (t =38.100,29.200,P＜0.05).The patients were followed up for 3 months to 5 years with a median time of 22 months.Of 166 patients,23 died,11 were loss to follow-up and others survived at the end of follow-up.Conclusion Three dividing lines is safe and feasible in radical right hemicolectomy for right colon cancer,with a good clinical efficacy.