To compare the short-and mid-term efficacy of laparoscopic radical resection for right-sided colon cancer using the hybrid approach versus the medial-to-lateral approach.

A retrospective analysis was performed on data from 103 patients with colon cancer who underwent laparoscopic radical resection for right-sided colon cancer from June 2018 to June 2024. Based on the surgical approach, 52 patients who underwent the hybrid approach were assigned to the hybrid approach group, and 51 patients who underwent the medial-to-lateral approach were assigned to the medial-to-lateral approach group. From the total sample, 44 obese patients (BMI ≥28kg/m²) were selected (23 in the hybrid approach group and 21 in the medial-to-lateral approach group) to form the obese subgroup; 41 patients with tumors located in the hepatic flexure were selected (21 in the hybrid approach group and 20 in the medial-to-lateral approach group) to form the hepatic flexure subgroup for subsequent subgroup analyses. Data were analyzed using SPSS 25.0 statistical software. Perioperative indicators and other measurement data with normal distribution were expressed as (±s), and inter-group comparisons were performed using independent samples t test; counting data such as postoperative complications and tumor recurrence-free rate were analyzed using χ² test. P<0.05 was considered statistically significant.

Compared with the medial-to-lateral approach group, the hybrid approach group had shorter operation time and less intraoperative blood loss (P<0.05). In the obese subgroup or the subgroup with tumors located in the hepatic flexure, the hybrid approach group showed shorter operation time, shorter postoperative exhaust time, and less intraoperative blood loss (P<0.05). There were no statistically significant differences between the two groups in the total incidence of postoperative complications or the 1-year and 3-year disease-free survival rates (P>0.05).

Both the hybrid approach and the medial-to-lateral approach are safe and feasible for laparoscopic radical resection of right-sided colon cancer. However, compared with the medial-to-lateral approach, the hybrid approach is associated with shorter operation time and less intraoperative blood loss. Additionally, the hybrid approach facilitates early postoperative gastrointestinal function recovery in patients with obesity or tumors located in the hepatic flexure.