Clinical observation of proximal and medium-term laparoscopic radical resection of right half colon cancer by combined cephalocaudal approach

doi:10.3877/cma.j.issn.1674-3946.2025.02.011.

Abstract

Abstract:

Objective

To investigate the short and medium term efficacy of laparoscopic radical resection of right half colon cancer by combined head and tail approach.

Method

Data of 99 patients with right half colon cancer who underwent laparoscopic radical resection from August 2018 to August 2021 were retrospectively analyzed, and divided into a cephalic group (n=49 cases, all cephalic approach) and a combined group (n=50 cases, combined cephalic and caudal approach) according to different approaches.SPSS 25.0 software was used to process the data.Measurement data such as surgery-related indicators and postoperative recovery indicators were represented by (x±s) and independent sample t test was used.The statistical data of complications and survival rate were expressed by［ cases (%)］ using χ² test.P＜0.05 was considered statistically significant.

Results

The operative time of the combined group was shorter than that of the cephalic group,and the number of intraoperative blood loss and vascular injury cases was lower than that of the cephalic group(P＜0.05).There was no significant difference in the time of first discharge, first feeding, drainage tube removal and hospital stay between the two groups (P＞0.05).There was no significant difference in the number of lymph nodes removed during operation, the total incidence of postoperative complications and the 2-year overall survival rate between the two groups (P＞0.05).

Conclusion

Compared with the complete cephalic approach,the combined cephalic and caudal laparoscopic radical resection of colon cancer can shorten the operation time,reduce the amount of intraoperative blood loss, and reduce the risk of vascular injury.The safety and nearmedium term prognosis of the combined cephalic and caudal approach for colon cancer are comparable.

Key words: Colonic Neoplasms, Laparoscopes, Postoperative Complications, Prognosis

Baohe Chen, Wenzhuo Zhang, Jun Wang. Clinical observation of proximal and medium-term laparoscopic radical resection of right half colon cancer by combined cephalocaudal approach[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2025, 19(02): 153-156.

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URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2025.02.011.

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Figures/Tables 4

组别	例数	性别（例）		年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）	TNM分期（例）
组别	例数	男	女	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）	Ⅱ/	Ⅲ
头侧组	49	26	23	66.2±7.1	4.7±1.1	23.3±2.3	28/	21
联合组	50	28	22	67.5±6.9	4.8±0.9	22.8±2.1	24/	26
t/χ²值		0.086		0.894	0.402	0.956	0.830
P值		0.769		0.373	0.688	0.342	0.362

组别	例数	性别（例）		年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）	TNM分期（例）
组别	例数	男	女	年龄（岁， $\overset{ˉ}{x}$ ±s）	肿瘤直径（cm， $\overset{ˉ}{x}$ ±s）	体重指数（kg/m²， $\overset{ˉ}{x}$ ±s）	Ⅱ/	Ⅲ
头侧组	49	26	23	66.2±7.1	4.7±1.1	23.3±2.3	28/	21
联合组	50	28	22	67.5±6.9	4.8±0.9	22.8±2.1	24/	26
t/χ²值		0.086		0.894	0.402	0.956	0.830
P值		0.769		0.373	0.688	0.342	0.362

组别	例数	手术时间（min， $\overset{ˉ}{x}$ ±s）	术中出血量（ml， $\overset{ˉ}{x}$ ±s）	术中血管损伤（例）	术中清扫淋巴结数目（枚， $\overset{ˉ}{x}$ ±s）
头侧组	49	142.6±22.4	86.8±15.3	9	16.7±2.4
联合组	50	125.4±20.0	69.3±7.2	2	17.2±2.6
t/χ²值		4.402	7.279	5.172	1.042
P值		＜0.001	＜0.001	0.023	0.300

组别	例数	手术时间（min， $\overset{ˉ}{x}$ ±s）	术中出血量（ml， $\overset{ˉ}{x}$ ±s）	术中血管损伤（例）	术中清扫淋巴结数目（枚， $\overset{ˉ}{x}$ ±s）
头侧组	49	142.6±22.4	86.8±15.3	9	16.7±2.4
联合组	50	125.4±20.0	69.3±7.2	2	17.2±2.6
t/χ²值		4.402	7.279	5.172	1.042
P值		＜0.001	＜0.001	0.023	0.300

组别	例数	首次排气时间（h）	首次进食时间（h）	拔除引流管时间（d）	住院时间（d）
头侧组	49	65.3±8.5	76.4±10.2	6.7±1.5	11.7±2.5
联合组	50	64.8±9.1	77.1±10.5	6.6±1.5	11.5±2.2
t值		0.276	0.362	0.248	0.371
P值		0.783	0.718	0.805	0.711

组别	例数	切口感染	肺部感染	肠梗阻	吻合口漏	总并发症
头侧组	49	1(2.0)	1(2.0)	0(0.0)	1(2.0)	3(6.1)
联合组	50	2(4.0)	1(2.0)	0(0.0)	0(0.0)	3(6.0)
χ ²值		-	-	-	-	0.157
P值		-	-	-	-	0.692

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