Objective To investigate the safety and efficacy of laparoscopic complete mesocolic excision (CME) with a medial-to-lateral approach for the treatment of right colonic cancer.Methods The clinical data of 46 patients with right colonic cancer who were admitted to the Longjiang Hospital from January 2010 to October 2013 were retrospectively analyzed.Twenty-four patients who received laparoscopic CME were in the laparoscopic group,and the other 22 patients who received open CME were in the control group.The intra-and postoperative condition and tumor recurrence of the 2 groups were compared.Patients were followed up till April 2014 after the operation.The measurement data were analyzed using the t test,and the count data were analyzed using the chi square test or Fisher exact probability.Results The operation was successfully done in the 2 groups.The operation time and intraoperative blood loss were (130 ± 26) minutes and (105 ± 29) mL in the laparoscopic group,and (156 ± 32)minutes and (136 ± 35)mL in the control group,with significant differences between the 2 groups (t =6.070,3.310,P＜0.05).The numbers of lymph nodes resected and lengths of resected specimen were 19 ± 4 and (28.0 ± 2.5)cm in the laparoscopic group,and 18 ± 4 and (26.8 ± 2.3)cm in the control group,with no significant differences between the 2 groups (t =0.560,1.770,P ＞0.05).The postoperative exhaust time and duration of postoperative hospital stay were (2.9 ±0.8)days and (12.3 ±2.7) days in the laparoscopic group,and (3.8 ±0.9)days and (14.1 ±2.2) days in the control group,with significant differences between the 2 groups (t =3.880,2.400,P ＜ 0.05).No operation-related complications was detected in the 2 groups.Forty-six patients were followed up for a mean time of 15 months (range,6-24 months).Two patients in the laparoscopic group and 2 in the control group were complicated with tumor local recurrence,with no significant difference between the 2 groups (P ＞ 0.05).No patients died during the follow-up.Conclusion Laparoscopic complete mesorectal excision with a medial-to-lateral approach for right colonic cancer is safe and feasible with satisfactory short-term outcome.

Objective To explore the clinical effect of tumescent anaesthesia in laparoscopic cholecystectomy(LC). Methods We analyzed the data of 71 patients who underwent LC for gallbladder benign disease. Anesthesia swelling fluid was injected in 37 cases before the operation in the gallbladder triangle( group D)and another 34 cases received no injection(group C). SBP,DBP,HR and Spo2 were monitored at 4 min before gallbladder traction(T1),1 min(T2),6 min(T3)and 11 min after gallbladder traction(T4),and when the gallbladder was dissected from gallbladder bed completely(T5). The operation time,intraoperative blood loss,postoperative exhaust time,time of getting out of bed after the surgery and length of stay were recorded. The gallbladder rupture, vascular injury ,bile duct injury ,intestinal injury ,placement of drainage tube ,intra-abdominal hemorrhage , intraoperative use of atropine or ephedrine and nausea and vomiting 24 hours after the operation were recorded. Results In group C,SBP,DBP and HR were significantly decreased at T2-T4 when compared with those at T1, and were significantly lower when compared with those in group D(P < 0.05). There was no significant difference in oxygen saturation between the two groups(P > 0.05). There were shorter operation time and less intraoperative blood loss in group D when compared with those in group C and the difference was statistically significant (P <0.05). The anus exhaust time,time of getting out of bed after the surgery,length of stay,intraoperative intra-abdominal hemorrhage and nausea and vomiting in the two groups indicated no statistical significance (P > 0.05). Gallbladder damage,vascular injury,placement of drainage tube and the incidence of adverse event were less in group D than those in group C. Conclusion Swelling anesthesia in LC can shorten the operation time ,induce less postoperative complications and maintain blood circulation stability.