Comparison of the efficacy of midcaudal combined approach and cephalic middle approach in laparoscopic complete mesocolic excision for right hemicolon cancer with incomplete ileus
10.3760/cma.j.issn.1008-6315.2020.02.006
- VernacularTitle:中间尾侧联合入路与头侧中间入路在右半结肠癌并发不全性肠梗阻患者腹腔镜下完整结肠系膜切除术中的效果比较
- Author:
Hongsheng ZHAO
1
;
Jiyong PAN
;
Ruifeng YAN
;
Zijun GUO
;
Longchao YAN
;
Xiaohai SONG
Author Information
1. 辽宁省大连市第三人民医院 大连市肿瘤医院普外科 116033
- From:
Clinical Medicine of China
2020;36(2):121-124
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of midcaudal combined approach and the cephalic middle approach in laparoscopic complete mesocolic excision (CME) in the treatment of right colon cancer complicated with incomplete intestinal obstruction.Methods:From January 2014 to January 2019, 90 patients with right colon cancer complicated with incomplete intestinal obstruction admitted to the Third People′s Hospital of Dalian were retrospectively analyzed.All patients underwent laparoscopic right hemicolectomy, CME plus D3 lymph node dissection.According to the choice of different surgical approaches, 44 patients were treated with the midcaudal combined approach (observation group) and the other 46 patients were treated with cephalic middle approach (control group). The intraoperative, postoperative and complications of the two groups were compared statistically.Results:Compared with the control group, the bleeding volume in the observation group was significantly reduced ((105.3±22.6) ml vs.(309.6±28.0) ml, t=13.698), the operation time was significantly shortened ((165.2±17.9) min vs.(219.5±21.5) min, t=8.327), and the differences were statistically significant (all P<0.05). There were no significant differences in the number of lymph nodes dissected ((21.4±7.8)vs.(20.4±6.6), t=0.534), the proportion of lymph nodes dissected≥12(86.4%(38/44)vs.84.8%(39/46), χ 2=0.208), the complications after operation(6.8%(3/44)vs.10.9%(5/46), χ 2=0.318), the length of hospital stay after operation ((11.8±1.6) d vs.(12.5±2.3) d, t=0.986), the difference was statistically significant (all P>0.05). Conclusion:It is safe and feasible to use the middle caudal approach in laparoscopic CME for right colon cancer complicated with incomplete ileus. Compared with the cephalic middle approach, it can reduce thebleeding volume and shorten the operation time.
