Du Wen-Feng, Liang Tang-Shuai, Guo Zong-Fei, Li Jian-Jun, Yang Cheng-Gang
Department of Gastrointestinal Surgery, Liaocheng People's Hospital, Liaocheng 252000, Shandong Province, China.
College of Clinical and Basic Medicine, Shandong First Medical University, Liaocheng 252000, Shandong Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):100476. doi: 10.4240/wjgs.v17.i4.100476.
Colon cancer is a significant health issue in China, with high incidence and mortality rates. Surgical resection remains the primary treatment, with the introduction of complete mesocolic excision in 2009 improving precision and outcomes. Laparoscopic techniques, including laparoscopic-assisted right hemicolectomy (LARH) and total laparoscopic right hemicolectomy (TLRH), have further advanced colon cancer treatment by reducing trauma, blood loss, and recovery time. While TLRH offers additional benefits such as faster recovery and fewer complications, its adoption has been limited by longer operative times and technical challenges.
To compare the short-term outcomes of TLRH and LARH for the treatment of right -sided colon cancer and explore the advantages and feasibility of TLRH.
Clinical data from 109 right-sided colon cancer patients admitted between January 2019 and May 2021 were retrospectively analyzed. Patients were divided into an observation group (TLRH, = 50) and a control group (LARH, = 59). Study variables were operation time, intraoperative bleeding volume, postoperative hospital stays, length of surgical specimen, number of lymph nodes dissected, and postoperative inflammatory factor levels of the two groups of patients. The postoperative complications were analyzed and compared, and survival, recurrence, and remote metastasis rates of the two groups were compared during a 2-year follow-up period.
The TLRH group showed the advantages of reduced intraoperative bleeding, shorter hospital stays, and quicker recovery. Lymph node dissection outcomes were comparable, and postoperative inflammatory markers were lower in the TLRH group. Complication rates were similar. Short-term follow-up (2 years) revealed no significant differences in recurrence, metastasis, or survival rates.
Compared to LARH, TLRH offers significant advantages in terms of reducing surgical trauma, lowering postoperative inflammatory factor levels, and mitigating the impact on intestinal function. This approach contributes to a shorter hospital stay and promotes postoperative recovery in patients. The study suggests that TLRH may offer favorable outcomes for colorectal cancer patients.
结肠癌在中国是一个重大的健康问题,发病率和死亡率都很高。手术切除仍然是主要的治疗方法,2009年引入的完整结肠系膜切除术提高了手术的精确性和治疗效果。腹腔镜技术,包括腹腔镜辅助右半结肠切除术(LARH)和全腹腔镜右半结肠切除术(TLRH),通过减少创伤、失血和恢复时间,进一步推动了结肠癌的治疗。虽然TLRH具有恢复更快、并发症更少等额外优势,但其应用受到手术时间较长和技术挑战的限制。
比较TLRH和LARH治疗右侧结肠癌的短期疗效,并探讨TLRH的优势和可行性。
回顾性分析2019年1月至2021年5月收治的109例右侧结肠癌患者的临床资料。将患者分为观察组(TLRH,n = 50)和对照组(LARH,n = 59)。研究变量包括两组患者的手术时间、术中出血量、术后住院时间、手术标本长度、清扫淋巴结数量和术后炎症因子水平。分析并比较术后并发症,并在2年随访期内比较两组的生存率、复发率和远处转移率。
TLRH组显示出术中出血减少、住院时间缩短和恢复更快的优势。淋巴结清扫结果相当,TLRH组术后炎症指标较低。并发症发生率相似。短期随访(2年)显示复发率、转移率或生存率无显著差异。
与LARH相比,TLRH在减少手术创伤、降低术后炎症因子水平和减轻对肠道功能的影响方面具有显著优势。这种方法有助于缩短住院时间并促进患者术后恢复。该研究表明,TLRH可能为结直肠癌患者带来良好的治疗效果。