A comparison of clinical outcomes between medium approach and lateral approach for complete mesocolic excision(CME) in radical right hemicolectomy

Objective To investigate the differences in surgical quality and clinical effect between medium approach and lateral approach for complete mesocolic excision(CME) in radical right hemicolectomy.Methods From March 2009 to March 2013, Seventy-three patients with right colon cancer underwent radical right hemicolectomy with CME principle. The patients were divided into medium approach group(n=36) and lateral approach group(n=37) according to the different surgical approach. The surgical quality and clinical outcomes were compared between the two groups. Results There were no significant differences in age, gender, preoperative coexistent diseases, history of abdominal operation, tumor location, TNM and Dukes' stages between the two groups. No differences were found in the operation time, volume of blood loss, length of resection margin, anal exhausting time, defecation time, time for abdominal drainage tube removal, time for postoperative feeding, and hospital stay between the two groups(P 0.05). More lymph nodes(17.83 vs. 15.82,P0.05), higher proportion of the resected specimens with excellent anatomic plane(91.7% vs. 67.6%,P0.05), less mean daily abdominal drainage(265.00 ml vs. 310.00ml,P0.05) were found in the medium approach group than those in the lateral approach group. There was no significant difference in postoperative morbidity between the two groups. There was no peri-operative death and reoperation for postoperative complications in the two groups. Conclusions The medium approach was in accord with radical right hemicolectomy resection under CME principle, with better anatomic plane and safety. The medium approach of CME is worthy of clinical application in the treatment of right colon cancer.