Xu Yexing, Tang Jiaxi, Kuo Paul C, Huang Renli, Zou Zhaowei
Department of General Surgery, Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
J Gastrointest Oncol. 2025 Jun 30;16(3):1339-1346. doi: 10.21037/jgo-2025-277. Epub 2025 Jun 27.
Colorectal cancer remains a significant threat to human life and health, with Laparoscopic technology represents a pivotal advancement in its treatment. Laparoscopic right hemicolectomy has emerged as the preferred surgical modality for managing right-sided colon cancer, offering minimally invasive benefits and expedited recovery. However, the right colon anatomy, characterized by complex vascular branching patterns and frequent variations, presents significant surgical challenges. Various surgical access methods have been proposed to address these challenges, each with distinct advantages and limitations. To optimize surgical outcomes, our research team has meticulously analyzed these approaches and developed a modified combined approach for laparoscopic right hemicolectomy in the treatment of right-sided colon cancer. This innovative approach integrates the strengths of different methods to enhance surgical efficacy while minimizing intraoperative bleeding, facilitating rapid recovery, and ensuring favorable prognosis. We report a case of a 76-year-old male with hypertension who presented with rectal bleeding. Preoperative evaluation revealed moderately differentiated adenocarcinoma in the ascending colon (clinical stage T3N1bM0). The patient underwent the modified combined approach of laparoscopic right hemicolectomy. The surgery was successful, with few intraoperative complications. Postoperatively, the patient had an uneventful recovery, was discharged after 8 days, and showed no signs of recurrence at 6-month follow-up. We anticipate that this novel surgical approach will provide more precise and efficient treatment options, ultimately improving the overall quality of life for patients with right-sided colon cancer.
结直肠癌仍然是对人类生命和健康的重大威胁，腹腔镜技术是其治疗中的一项关键进展。腹腔镜右半结肠切除术已成为治疗右侧结肠癌的首选手术方式，具有微创优势且恢复快。然而，右半结肠的解剖结构特点是血管分支模式复杂且变异频繁，这带来了重大的手术挑战。已提出各种手术入路方法来应对这些挑战，每种方法都有其独特的优缺点。为了优化手术效果，我们的研究团队精心分析了这些方法，并开发了一种改良的联合方法用于腹腔镜右半结肠切除术治疗右侧结肠癌。这种创新方法整合了不同方法的优势，以提高手术疗效，同时减少术中出血，促进快速恢复，并确保良好的预后。我们报告一例76岁男性高血压患者，因直肠出血就诊。术前评估显示升结肠中分化腺癌（临床分期T3N1bM0）。该患者接受了腹腔镜右半结肠切除术的改良联合方法。手术成功，术中并发症少。术后，患者恢复顺利，8天后出院，6个月随访无复发迹象。我们预计这种新颖的手术方法将提供更精确、高效的治疗选择，最终改善右侧结肠癌患者的整体生活质量。
