Abstract:

Objective

To explore the therapeutic effect of laparoscopic radical resection via the head-side and central mixed approach for right-sided colon cancer.

Methods

The clinical data of 36 patients with right-sided colon cancer who underwent laparoscopic radical resection via the head-side and central mixed approach from May 2018 to May 2023 were retrospectively collected (mixed group). At the same time, the clinical data of 36 patients who underwent the central approach were collected (control group). The statistical software SPSS 25.0 was used for analysis. Measurement data such as preoperative and intraoperative indexes were described by (), and t test was performed; Enumeration data such as complications were described by［ cases (%)］, and chi-square test was performed. The survival situation was analyzed by the Kaplan-Meier curve.

Results

The intraoperative blood loss in the mixed group was less than that in the control group, and the operation time was shorter than that in the control group (P<0.05). There was no significant difference in the number of lymph node dissections between the two groups (P>0.05). There were no significant differences in postoperative indexes such as the first meal intake and the first exhaust after surgery between the two groups(P>0.05). There was no conversion to open surgery in the mixed group, while there was 1 case in the control group. There was no significant difference in the conversion rate to open surgery between the two groups (P>0.05).One week after surgery, the levels of gastrin (GAS) and motilin (MTL) in both groups of patients decreased,and the differences were statistically significant (P<0.05); however, there was no significant difference between the two groups (P>0.05). One week after surgery, the levels of carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA199), and CA125 in both groups of patients decreased (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The follow-up period was 6 to 12 months, and the median follow-up period was 12 months. There was no significant difference in the survival situation between the two groups (Log-Rank χ²=0.765, P=0.382).

Conclusion

Compared with the central approach, the head-side and central mixed approach for patients with right-sided colon cancer can achieve a comparable long-term curative effect, but it can effectively shorten the operation time and reduce the intraoperative blood loss.

Key words: Right-Sided Colon Cancer, Laparoscopic Radical Resection of Right Colon Cancer, Head Side Central Mixed Approach, Central Approach