Clinical efficacy of laparoscopic complete mesorectal excision with a medial-to-lateral approach for right colonic cancer

Objective To investigate the safety and efficacy of laparoscopic complete mesocolic excision (CME) with a medial-to-lateral approach for the treatment of right colonic cancer.Methods The clinical data of 46 patients with right colonic cancer who were admitted to the Longjiang Hospital from January 2010 to October 2013 were retrospectively analyzed.Twenty-four patients who received laparoscopic CME were in the laparoscopic group,and the other 22 patients who received open CME were in the control group.The intra-and postoperative condition and tumor recurrence of the 2 groups were compared.Patients were followed up till April 2014 after the operation.The measurement data were analyzed using the t test,and the count data were analyzed using the chi square test or Fisher exact probability.Results The operation was successfully done in the 2 groups.The operation time and intraoperative blood loss were (130 ± 26) minutes and (105 ± 29) mL in the laparoscopic group,and (156 ± 32)minutes and (136 ± 35)mL in the control group,with significant differences between the 2 groups (t =6.070,3.310,P＜0.05).The numbers of lymph nodes resected and lengths of resected specimen were 19 ± 4 and (28.0 ± 2.5)cm in the laparoscopic group,and 18 ± 4 and (26.8 ± 2.3)cm in the control group,with no significant differences between the 2 groups (t =0.560,1.770,P ＞0.05).The postoperative exhaust time and duration of postoperative hospital stay were (2.9 ±0.8)days and (12.3 ±2.7) days in the laparoscopic group,and (3.8 ±0.9)days and (14.1 ±2.2) days in the control group,with significant differences between the 2 groups (t =3.880,2.400,P ＜ 0.05).No operation-related complications was detected in the 2 groups.Forty-six patients were followed up for a mean time of 15 months (range,6-24 months).Two patients in the laparoscopic group and 2 in the control group were complicated with tumor local recurrence,with no significant difference between the 2 groups (P ＞ 0.05).No patients died during the follow-up.Conclusion Laparoscopic complete mesorectal excision with a medial-to-lateral approach for right colonic cancer is safe and feasible with satisfactory short-term outcome. Key words: Colonic neoplasms;  Laparoscopy ;  Complete mesocolic excision