Abstract
Objective: To investigate the short-term efficacy of laparoscopic radical resection of right-sided colon cancer with two different surgeon positions and trocar placements. Methods: The data of 78 patients who underwent laparoscopic radical resection of right-sided colon cancer between January 2018 and August 2019 were retrospectively analysed. The surgical method was selected by the patients. The patients were divided into two groups according to the surgeons’ positioning habits and trocar placements. The group with the lead surgeon standing between the patient’s legs had 35 patients, and the group with the lead surgeon standing at the left side of the patient had 43 patients. The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups. Results: All patients underwent the laparoscopic radical resection of right-sided colon cancer, none converting to laparotomy. No significant difference (P > 0.05) in intraoperative blood loss (57.6 ± 21.3 ml vs 60.2 ± 35.3 ml), postoperative anal gas evacuation time (3.5 ± 1.1 d vs 3.8 ± 1.3 d), postoperative urinary catheter indwelling time (2.6 ± 1.3 d vs 2.4 ± 1.2 d), postoperative hospital stay (7.1 ± 1.8 d vs 7.5 ± 2.1 d), or CRP level on the first day after surgery (54.7 ± 9.6 mg/L vs 53.9 ± 8.2 mg/L) was detected between the two groups. The operation time was shorter in the group with the lead surgeon standing between the patient’s legs (185.2 ± 25.6 min vs 196.2 ±19.7 min) (P 0.05). No patients died or had anastomotic fistula during their postoperative hospital stay, and the incidence of postoperative complications did not differ between the two groups (22.9% (8/35) vs 23.3% (10/42); P > 0.05). Conclusion: Under the principle of radical resection, the surgeon should adopt the most suitable standing position and trocar placement according to the specific situation. If the surgeon stands between the patient’s legs, this might shorten the operation time and promote a smoother surgery.
Highlights
Right-sided colon cancer is a common malignant tumour of the digestive tract and has a higher mortality rate than other colon cancers for multiple reasons, such as genetics, eating habits, and living habits
The operation time, intraoperative blood loss, postoperative anal gas evacuation time, postoperative urinary catheter indwelling time, postoperative hospital stay, C-reactive protein (CRP) level on the first day after surgery, and postoperative pathological data and complications were compared between the two groups
This study collected the data of patients who underwent laparoscopic radical resection of right-sided colon cancer in our department between January 2018 and August 2019 and compared the safety, radical therapeutic effect, and short-term efficacy between two different surgeon positions and trocar placements
Summary
Right-sided colon cancer is a common malignant tumour of the digestive tract and has a higher mortality rate than other colon cancers for multiple reasons, such as genetics, eating habits, and living habits. The incidence rate of right-sided colon cancer has been increasing in recent years [1]. Surgical resection is still the main treatment for right-sided colon cancer. With the popularization of laparoscopic surgery and the adoption of the concept of complete mesocolectomy, the resection scope of right-sided colon cancer surgery has been further standardized. The surgical technique of laparoscopic radical resection of right-sided colon cancer has matured. Some details remain to be standardized, such as the standing position of the surgeon and the trocar placement location. This study collected the data of patients who underwent laparoscopic radical resection of right-sided colon cancer in our department between January 2018 and August 2019 and compared the safety, radical therapeutic effect, and short-term efficacy between two different surgeon positions and trocar placements
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