Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.100476
Revised: January 13, 2025
Accepted: February 18, 2025
Published online: April 27, 2025
Processing time: 223 Days and 6.6 Hours
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, n = 50) and a control group (LARH, n = 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.
Core Tip: This retrospective study compared the outcomes of total laparoscopic right hemicolectomy (TLRH) and laparoscopic-assisted right hemicolectomy in right-sided colon cancer patients. TLRH demonstrated the advantages of reduced intraoperative bleeding, shorter hospital stays, and lower postoperative inflammation, while maintaining similar outcomes in lymph node dissection and complication rate. Additionally, no significant differences were observed in survival, recurrence, or metastasis rates over a 2-year follow-up period. The findings suggest that TLRH is a feasible approach that minimizes surgical trauma and enhances postoperative recovery.