Laparoscopic radical right hemicolectomy via medial approach for colon cancer

Abstract

Objective To explore the surgical techniques and key points of laparoscopic radical right hemicolectomy for colon cancer. Methods The clinical data of 84 patients with colon cancer who underwent laparoscopic radical right hemicolectomy at the General Hospital of Lanzhou Military Command from November 2012 to June 2014 were retrospectively analyzed. The tumors were located at the hepatic flexure of the colon, the ascending colon and the ileocecum. The inside-out and up-down medial approach was used as the main surgical approach, and D3 lymph node dissection based on a center of surgical trunk of the superior mesenteric vein was the key point of laparoscopic radical right hemicolectomy. The intraoperative and postoperative conditions of patients were observed. Patients were followed up by telephone interview, text message and examination of readmission till March 2015. Results Of 84 patients, 82 received laparoscopic radical right hemicolectomy and 2 were converted to open operation without perioperative death. The mean operation time, volume of intraoperative blood loss, number of lymph node dissection, postoperative gastrointestinal recovery time and duration of hospital stay were 125 minutes (range, 110-175 minutes) , 50 mL (range, 30-120 mL) , 17 (range, 13-20) , 52 hours (range, 24-72 hours) and 6 days (range, 5-10 days) , respectively. There were no complications such as ureter injury, duodenal injury, anastomotic fistula, abdominal abscess and surgery-related complications. Seventy-two patients were followed up for a median time of 21 months (range, 12-28 months) without the tumor metastasis of abdominal incision and sites of puncture. Conclusion Laparoscopic radical right hemicolectomy via the medial approach is safe and feasible as well as improving the prognosis of patients, and lymph node dissection based on a center of surgical trunk of the superior mesenteric vein is the key point of surgery. Key words: Colonic neoplasms; Laparoscopy; Surgical procedures, operative; Surgical key points