To investigate the clinical effect of laparoscopic complete mesocolectomy (CME) for right colon cancer through caudal and medical approach.

The clinical data of 84 patients who underwent CME for right colon cancer from March 2017 to July 2018 were retrospectively analyzed. The patients were divided into caudal group (n=45) and intermediate caudal combined group (n=39) according to different surgical approaches. SPSS 22.00 statistical software was used for data analysis. Perioperative indicators, CME quality and other measurement data were expressed by (±s), independent t test was used; The incidence of complications, CME completion rate were measured by χ² or Fisher’s exact test.The survival rate of the two groups was compared by Log Rank test. P<0.05 was considered statistically significant.

The operative time and intraoperative blood loss in the combined group were less than that in the caudal group, and the difference was statistically significant (P<0.05). The total incidence of postoperative complications was 11.1% in the caudal group and 7.7% in the combined group. There was no significant difference in the total incidence of postoperative complications between the two groups (P>0.05). In terms of CME completion quality, there were no significant differences in CME completion rate, mesangial integrity grading, mesangial area excised, vascular ligation site, colon length excised, and number of lymph nodes dissected between the two groups (P>0.05). There was no death within 2 years of postoperative follow-up in both groups, and 1 case was lost to follow-up in the combined group. There was no significant difference in 2-year disease-free survival rate (DFS) between the combined group and the caudal group (94.9% vs. 93.3%, P>0.05).

CME combined with caudal median approach has more advantages than caudal approach in shortening operative time and reducing intraoperative blood loss, and its safety, CME completion quality and short-term efficacy are comparable with caudal approach.