To analyze the clinical outcome of laparoscopic expanded right hemicolectomy through caudal and/or medial approach for right colon carcinoma.

Clinical data of 50 patients with colon cancers located at liver flexure who underwent laparoscopic expanded right hemicolectomy from January 2017 to June 2019 were analyzed retrospectively. According to different surgical approaches, patients were divided into caudal group (n=25) and traditional group (n=25). Patients in the caudal group received laparoscopic surgery through caudal and medial approach, while patients in the traditional group received laparoscopic surgery through medial approach. SPSS22.0 software was used for statistical analysis. Measurement data such as perioperative indexes and blood inflammation indexes were expressed by (±s), and were examined by using independent t test. The statistical data of postoperative complications was examined by using χ² test. A P value of <0.05 was considered as statistically significant difference.

Compared with the perioperative indicators in the traditional group, the operation time, exhausting time and drainage tube removal time in the caudal group were significantly shortened, and intraoperative bleeding was significantly reduced, with statistically significant differences (P<0.05). On the 7th day after surgery, the serum levels of CRP, TNF-α and IL-6 in the caudal group were significantly better than those in the traditional group (P<0.05). Postoperative complications in the caudal group were significantly lower than those in the traditional group (12.0% vs 36.0%, P<0.05). Follow-up ranged from 12 to 49 months, no perioperative death, recurrence and distant tumor metastasis occurred in both 2 groups.

Caudal/medial approach is safe and effective in laparoscopic surgery for patients with colon cancer located at liver flexure, with advantages such as simpler operation, less operative time, less intraoperative bleeding, shorter hospitalization time, and fewer complications.