Effect of laparoscopic radical resection based on membrane anatomy vs traditional laparoscopic procedure for the treatment of right colonic cancer
10.3760/cma.j.cn113855-20230815-00057
- VernacularTitle:基于膜解剖的腹腔镜右半结肠癌根治术与传统腹腔镜手术疗效的对比研究
- Author:
Huiyuan JIANG
1
;
Qian ZHAO
;
Sheng GAO
;
Lichun WANG
;
Jian MA
;
Shuai JIAO
;
Bo JIANG
Author Information
1. 山西省肿瘤医院 中国医学科学院肿瘤医院 山西医院 山西医科大学附属肿瘤医院结直肠外科，太原030013
- Keywords:
Colonic neoplasms;
Mesocolon;
Colectomy;
Laparoscopy
- From:
Chinese Journal of General Surgery
2024;39(8):577-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of laparoscopic right colon cancer radical resection(CME+D3,60 cases) based on membrane anatomy and traditional laparoscopic right colon cancer radical resection(CME/D3, 120 cases).Methods:A retrospective cohort study was used to collect the consecutively admitted cases undergoing laparoscopic radical right colon cancer resection at the Department of Colorectal Surgery, Shanxi Hospital from Jan 2018 to Jun 2020.The postoperative data , postoperative complications, follow-up outcomes were compared between the two groups.Results:Compared with the CME/D3 group, that the based on membrane anatomy(CME+D3) group had a decreased intraoperative blood loss [(79.3±16.7) ml vs. (103.6±20.8) ml, t=-3.894, P<0.001],and more lymph node harvest [(27.0±5.1) vs. (25.1±6.2), t=2.138, P=0.034]; The sectional grading of surgical specimens was also better than that in the traditional operation group(χ 2=4.146, P=0.042); while the operation time was slightly longer than that of the traditional operation group [(161.1±18.4) minutes vs.(142.6±19.5) minutes, t=-6.166, P<0.001]. There was no significant difference in the length of specimen resection, postoperative exhaust time, hospital stay, incidence of postoperative complications, proportion of unplanned reoperation within 30 days, re-admission within 30 days, and mortality within 30 days ( all P>0.05). The median follow-up time was 36.7 (5.3-48.7) months, and there was no significant difference in overall survival rates between the two groups ( P>0.05); The difference in disease-free survival rates between the two groups is significant(χ 2=4.246, P=0.039). Conclusions:Compared with the traditional laparoscopic right colon cancer radical surgery (CME/D3),laparoscopic radical resection of right colon cancer (CME+D3) based on membrane anatomy reduces intraoperative bleeding, improves the number of lymph node dissection and specimen quality, and has higher 1-year and 3-year disease-free survival rate .
