Shor-term effects of laparoscopic right hemicolon cancer radical resection with ‘the three approaches in separation’

Objective:To investigate the short-term effects of laparoscopic right hemicolon cancer radical resection with ‘the three approaches in separation’.
Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 57 patients with right hemicolon cancer who were admitted to Henan Provincial People′s Hospital between December 2018 and December 2019 were collected. There were 32 males and 25 females, aged from 21 to 81 years, with a median age of 68 years. Patients underwent laparoscopic assisted radical resection of right hemicolon cancer. Observation indicators: (1) surgical situations and postoperative recovery; (2) postoperative histopathological examination. Measurement data with skewed distribution were represented as M (range), and count data were described as absolute numbers.
Results:(1) Surgical situations and postoperative recovery: all 57 patients underwent laparoscopic radical resection of right hemicolon cancer with ‘the three approaches in separation’. There was no intraoperative conversion to laparotomy. Of 57 patients, 5 underwent laparoscopic multiple organ resection including 2 combined with gastric wall wedge resection, 2 combined with partial duodenectomy and 1 combined with splenectomy. During operation, 57 patients underwent nasointestinal tube indwelling for postoperative enteral nutrition, and double cannula placeing around duodenum for continuous irrigation and suction. Operation time, volume of intraoperative blood loss, and time to first flatus were 110 minutes(range, 80-230 minutes), 50 mL(range, 10-130 mL), 2 days(range, 1-3 days), respectively. Of 57 patients, 4 had postoperative incision infection, 3 had pulmonary infection, 1 had adhesive intestinal obstruction, and they were cured after conservative treatment. Duration of postoperative hospital stay of 57 patients were 7 days(range, 5-17 days). (2) Postoperative histopathological examination: of 57 patients, the number of lymph nodes dissected and length of surgical specimen were 21(range, 13-27) and 30 cm(range, 25-50 cm). All 57 patients had negative surgical margin. Cases in stage pT1, pT2, pT3, pT4(pT staging) and cases in stage pN0, pN1, pN2(pN staging) were 5, 23, 24, 5 and 17, 27, 13, respectively. All 57 patients were in pathological M0 stage, without tumor distant metastasis. Pathological types of 57 patients: there were 7 patients with mucinous adenocarcinoma, 5 with poorly differentiated adenocarcinoma, 18 with moderately differentiated adenocarcinoma, 27 with well differentiated adenocarcinoma.
Conclusion:‘The three approaches in separation’ is safe and feasible in the laparoscopic radical resection of right hemicolon cancer.