Objective To compare the effects of laparoscopic surgery with various approaches on intestinal barrier function,red blood cell immunity,and prognosis in patients with right hemicolectomized colon cancer.Methods A prospective selection of 110 patients with right hemicolectomized colon cancer admitted to our hospital from April 2019 to April 2021 was conducted.Patients were divided into groups A(n= 55)and B(n= 55)using a simple randomization method.During the treatment period,two cases of loss of follow-up occurred in Group A and three in Group B.Finally,53 from Group A and 52 participants from Group B completed the study.Both groups underwent laparoscopic surgery.Group A underwent a cephalic approach,whereas Group B underwent an intermediate approach.The periopera-tive indexes,complications,prognosis,intestinal barrier function(endotoxin,D-lactic acid,and diamine oxidase),red blood cell immune complex rate(RBC-ICR),RBC-C3b receptor rosette rate(RBC-C3bRR),and erythrocyte adhesion to tumor cell rosette rate(TRR)of the two groups were determinedd.Results Group A had less intraoperative bleeding,shorter central lymph node dissection time,shorter operative time,and lower complication rate(P＜0.05)than Group B.Endotoxin,diamine oxidase,and D-lactate levels in both groups were higher 3 d after surgery than before surgery(P＜0.05).Three days after surgery,the RBC-ICR of both groups was higher than before surgery,whereas the TRR and RBC-C3bRR were lower than before surgery(P＜0.05).After 1 year of follow-up,no statistically sig-nificant difference in distant metastasis,local recurrence,and survival rates were observed between the two groups(P＞0.05).Conclusion The two approaches used in this study have similar effects in right hemicolectomized colon cancer.The cephalic approach for laparoscopic sur-gery shortened the surgical time and reduced complications.