Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2025; 17(4): 100476
Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.100476
Comparison of outcomes of laparoscopic-assisted and total laparoscopic right hemicolectomy for right-sided colon cancer
Wen-Feng Du, Tang-Shuai Liang, Zong-Fei Guo, Jian-Jun Li, Cheng-Gang Yang
Wen-Feng Du, Tang-Shuai Liang, Jian-Jun Li, Cheng-Gang Yang, Department of Gastrointestinal Surgery, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Zong-Fei Guo, College of Clinical and Basic Medicine, Shandong First Medical University, Liaocheng 252000, Shandong Province, China
Author contributions: Du WF and Yang CG designed the research protocols for the present study, and provided guidance for writing and revising the article; Liang TS wrote the article and conducted the statistical analyses; Guo ZF collected the clinical data and abstracted the data; Li JJ participated in modification and data analysis; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Liaocheng People’s Hospital, approval No. 2022173.
Informed consent statement: Due to retrospective study design, informed consent was waived by Liaocheng People’s Hospital Ethics Committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All relevant data are included in the paper, and no additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Gang Yang, MD, Professor, Department of Gastrointestinal Surgery, Liaocheng People’s Hospital, No. 67 Dongchang West Road, Liaocheng 252000, Shandong Province, China. bakerham123@163.com
Received: August 18, 2024
Revised: January 13, 2025
Accepted: February 18, 2025
Published online: April 27, 2025
Processing time: 223 Days and 6.6 Hours
Abstract
BACKGROUND

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.

AIM

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

Keywords: Laparoscopic complete mesocolic excision; Total laparoscopic right hemicolectomy; Laparoscopic-assisted right hemicolectomy; Right-sided colon cancer; Short-term outcomes

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.