Clinical Efficacy Of Totally Laparoscopic Overlap Anastomosis In Radical Resection Of Right Colon Cancer

Objective: To assess the short-term and long-term clinical efficacy of TLRC in the treatment of right colon cancer,clinical data from TLRC intracorporeal anastomosis and LARC extracorporeal anastomosis were compared.Methods: We retrospectively collected and analyzed clinical data of patients with right colon cancer diagnosed in the Department of Gastrointestinal Surgery at Jiangxi Provincial People’s Hospital between January 2018 and February 2021.Eligible patients were screened according to the inclusion and exclusion criteria and divided into TLRC and LARC groups based on the location of the ileocolic anastomosis space.We gathered clinical data from the two groups on general perioperative information,intraoperative conditions,postoperative complications,postoperative recovery,postoperative pathological findings,and postoperative follow-up results.Finally,SPSS26.0 statistical software was used for statistical analysis.P<0.05 indicated that the differences were statistically significant.Results: A total of 86 patients were included in the study,with 40 in the TLRC group(22 males and 18 females)and 46 in the LARC group(26 males and 20 females).There was no statistical difference in the general information between the two groups of patients(P>0.05).In terms of intraoperative conditions,the TLRC group had a significantly longer operative time(180.78±20.76 min vs.171.61±19.87 min;P=0.040)and anastomosis time(24.83±6.50 min vs.16.57±6.26 min;P<0.001)than the LARC group.Compared with the LARC group,the skin incision length was shorter in the TLRC group(5.64±1.27 cm vs.8.23±1.71 cm;P<0.001).There were no significant differences in intraoperative conversion rate and intraoperative blood loss between the two groups(P>0.05).In terms of postoperative complications,the TLRC group had a significantly lower overall complication rate than the LARC group [4(10%)vs.13(28.3%);P=0.034].There was no statistically significant difference between the two groups in terms of complications such as AL,anastomotic bleeding,abdominal bleeding,abdominal infection,incisional infection,intestinal obstruction,gastroparesis,chylous fistula,and incisional hernia(P>0.05).In terms of postoperative recovery,the TLRC group was better than the LARC group in terms of time to first postoperative exhaust(3.00±1.15 d vs.3.51±1.09 d;P=0.038),time to first postoperative stool(3.64±1.22 d vs.4.14±1.02 d;P=0.042),and time to first oral intake after surgery(3.37±1.25 d vs.3.91±1.14 d;P=0.037).Compared to the LARC group,the TLRC group had a shorter duration of abdominal drainage tube retention(4.55±1.22 d vs.5.10±1.08 d;P=0.031)and less pain on postoperative day 3[2(2)vs.3(2);P=0.003].In terms of postoperative hospital stay and postoperative pain scores on days 1,2,and 4,there were no significant differences between the two groups(P>0.05).In terms of postoperative pathological findings,there were no significant differences between the two groups in the number of lymph node dissections,the number of positive lymph nodes,nerve invasion,vascular invasion,specimen length,tumor differentiation degree,tumor growth pattern and pathological stage(P>0.05).In terms of postoperative follow-up results,there were no significant differences in DFS and OS between the two groups at 2 years after surgery(P>0.05).Conclusions: TLRC has the advantages of fewer complications,faster recovery of bowel function,less trauma,and comparable oncologic outcomes and long-term survival to LARC,but with longer operative time and intracorporeal anastomosis time.