Comparison Of Clinical Outcomes Of Different Laparoscopic Approaches For Right Colon Cancer Under The Concept Of CME

Objective:To compare the efficacy and safety of laparoscopic internal and external approaches for right colon cancer under the concept of CME,and to provide data support for standardized surgeryMethods:Screening patients who were admitted to Yantai Affiliated Hospital of Binzhou Medical University from July 2015 to June 2018 and were diagnosed as right colon cancer by electronic colonoscopy and imaging examination.Fifty-one patients were randomly divided into medial group(M group,26 cases)and lateral group(L group,25 cases).The data of operation,complications and recovery were compared between the two groups.Results:The operation time was(128.9±30.18)min in group M,(4.64±4.21)in lymph nodes in group D3,(3.46±1.91)days in exhaust,(5.12±1.98)days in semi-fluid diet,(8.98±3.26)days in hospital after operation,(110.2 ± 30.67)minutes in group L,(2.31±3.71)days in lymph nodes in group D3,(4.81 ± 1.61)days in exhaust,(7.35±3.53)days in semi-fluid diet,and stay after operation.The total hospital stay was(12.72±5.31)days.The difference between the two groups was significant(P<0.05).In group M,the amount of bleeding(62.3±52.3)ml,the number of lymph nodes at D1(5.24 ± 4.41),the number of lymph nodes at D2(5.84 ± 3.64),the length of incision(7.90 ± 2.31)cm,the length of specimen(25.91 ± 5.26),the time of postoperative analgesia(5 ± 1.5)d,the cost of hospitalization(36254.3 ± 5703.87)yuan,the amount of bleeding in group L(81.7±53.4)ml,the number of lymph nodes at D1(5.54+3.88),the number of lymph nodes at D2(4.94±4.12),the incision.There were no significant differences in length(7.45±2.68)cm,specimen length(26.16 ± 5.32)cm,postoperative analgesia time(4±2.1)d,hospitalization expenses(33772.5± 53021)yuan between the two groups(P>0.05).The intraoperative injury and complications of the two groups were basically the same,and there was no statistical significance(P>0.05)Conclusion:For the right colon,laparoscopic CME is safe in both ways.The lateral approach has the advantage of shortening the operation time and is less difficult.The medial approach has the characteristics of thorough lymph node dissection at D3 station and rapid recovery after operation,which has great potential and deserves further development.