Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 17, Pan Jia Yuan Nan Li, Chaoyang District, Beijing, 100021, People's Republic of China.
Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100021, China.
World J Surg Oncol. 2020 Jul 7;18(1):159. doi: 10.1186/s12957-020-01922-8.
To evaluate the feasibility and safety of a new surgical method, complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction in right-transverse colon cancer.
We retrospectively analyzed and compared the data of consecutive patients with right-transverse colon cancer who underwent complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction (n = 23) and conventional complete laparoscopic extended right hemicolectomy (n = 34) in our hospital between October 2017 to May 2019, respectively.
The overall operation time of the ileocecal junction-preserved group was significantly shorter than that of the control group (p = 0.048). There was no difference in the number of harvested lymph nodes, metastatic lymph nodes, and rate of metastatic lymph nodes (p > 0.05). The ileocecal junction-preserved group showed shorter time of first flatus, lower frequency of postoperative diarrhea, and shorter duration of postoperative hospitalization. Furthermore, it also showed that the defecation frequency was lower in the ileocecal junction-preserved group than the control group on the 1st, 3rd, and 6th month (p < 0.05), and the number of patients who defecated at night or defecated four times or more a day was less in the ileocecal junction-preserved group than control group on the 1st month (p < 0.05).
The complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction promises as a safe and feasible surgical procedure for right-transverse colon cancer, associated with earlier recovery of bowel function, shorter operation time, and similar pathological outcomes when compared to the conventional laparoscopic procedure.
评估保留回盲部的全腹腔镜右半横结肠癌扩大根治术的可行性和安全性。
回顾性分析我院 2017 年 10 月至 2019 年 5 月连续收治的 23 例右半横结肠癌患者行保留回盲部的全腹腔镜右半结肠扩大根治术（观察组）与 34 例行传统全腹腔镜右半结肠扩大根治术（对照组）的临床资料。
观察组手术时间明显短于对照组（p = 0.048）。两组淋巴结清扫总数、转移淋巴结数、转移淋巴结率比较差异无统计学意义（p > 0.05）。观察组术后首次排气时间、腹泻发生率、术后住院时间均短于对照组。观察组术后 1、3、6 个月排便次数均少于对照组（p < 0.05），且术后 1 个月排便次数≥4 次、夜间排便者少于对照组（p < 0.05）。
与传统腹腔镜手术相比，保留回盲部的全腹腔镜右半横结肠癌扩大根治术安全可行，具有恢复更快、手术时间更短、术后病理结果相似等优点。
