L. Zou1, B. Zheng1, L. Zou1 1Guangdong Provincial Hospital Of Chinese Medicine,Department Of Gastrointestinal Surgery,Guangzhou, GUANGDONG, China
Introduction:
The aim of this study is to compare the safety and feasibility of laparoscopic radical right hemicolectomy using caudal -to-cranial (CtC) approach versus medial-to-lateral (MtL) approach.
Methods:
Using data from a clinical database in our department, we retrospectively analyzed data of 78 cases undergoing laparoscopic radical right hemicolectomy using CtC approach, matching with using MtL approach from January 2013 and October 2015. The matching factors consisted of gender, age, ASA score, BMI, tumor size, tumor location and TNM stage. Data of intraoperative and postoperative characteristics were reviewed.
Results:
The data of clinicopathological characteristics were similar in both groups. In the intraoperative and postoperative characteristics, there are no significant differences in average time of ambulation, time to first flatus, hospital stay between two groups, but there are significantly shorter operation time (173.9±25.39 min vs.193.5±39.55 min. P = 0.0002) and less blood loss (92.0±21.21ml vs. 107.3±24.67ml. P < 0.0001) in the CtC group than that in the MtL group. The number of lymph nodes dissected in the CtC group is more (26.3±10.92 vs.22±8.93. P = 0.007). The rate of hemorrhage of the major vessels (SMA, SMV, ICV/ICA, RCV/RCA, Henle’s trunk, MCV/MCA) in the CtC group was significantly lower (14.1% vs. 3.8%. P = 0.025).
Conclusion:
Laparoscopic radical right hemicolectomy using CtC approach is technically feasible for curable right-sided colon cancer with less blood loss compared with MtL approach, especially in the major vessel injury.