Total Laparoscopic Right Hemicolectomy With 3-step Stapled Intracorporeal Isoperistaltic Ileocolic Anastomosis For Colon Cancer:An Evaluation Of Short-term Outcomes

Colorectal cancer is the third most common malignant tumor in men and the second in women worldwide.The 5-year overall survival rate is 65%,and 10-year overall survival rate is 58%.Surgical resection of primary tumor is still the only way of curing the cancer,and laparoscopic surgery has been widely recognized and applied nowadays.Laparoscopic surgery has gained wide acceptance and has been increasingly performed over the years.The first case of laparoscopic right hemicolectomy for colon cancer was reported in1991.Because of its special anatomical position,laparoscopic right hemicolectomy requires higher standard in technical conditions than the left colon and rectal surgery.Laparoscopic right hemicocele anastomosis has become the main concern that domestic and foreign scholars focus in recent years.Laparoscopic assisted right hemicolectomy with extracorporeal anastomosis is a widely used surgical approach.Extracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for cancer has a significant risk of complications.To overcome these complications,total laparoscopic right hemicolectomy with isoperistalic intracorporeal anastomosis also has been reported by several scholars.In this paper,we retrospective review of colon cancer patients treated with laparoscopic right hemicolectomy either with intracorporeal anastomosis?TLG group?or extracorporeal anastomosis?LG group?.Operative and postoperative data are compared.We present 3-step stapled intracorporeal isoperistaltic ileocolic anastomosis and compared the short-term outcomes in patients with colon cancer with extracorporeal anastomosis.Part I:Analyze of perioperative period conditions of total laparoscopic right hemicolectomy with 3-step stapled intracorporeal isoperistaltic ileocolic anastomosis for colon cancerObjective:To evaluate the safety and efficiency of laparoscopic right hemicolectomy for colon cancer patients and compare the perioperative period conditions of both intracoporeal anastomosis and extracorporeal anastomosisMethods.Method:We reviewed patients whose post operative histology diagnosis were T_1-3N_XM₀ colon cancer from January 2011 to October 2015.Among which,56 patients who underwent total laparoscopic right hemicolectomy with 3-step stapled intracorporeal isoperistaltic ileocolicanastomosis and 29 patients who underwent laparoscopic assisted right hemicolectomy with extracorporeal anastomosis.Compared the clinicopathological data and performed statistics analysis between two groups.Results:All 85 patients completed laparoscopic right hemicolectomy successfully,without converting into open surgery or other major morbidities.The average surgical time,number of lymph node clearance and total hospital stay did not vary between two groups.However,three step intracoporeal anastomosis outweighs the extracorporeal anastomosis in anastomosis time,operative blood loss,and post operative pain.Conclusion:Total laparoscopic right hemicolectomy with 3-step stapled intracorporeal anastomosis for colon cancer is a safe and reliable procedure.Its advantages include short anastomosis time,less intraoperative blood loss,less postoperative pain,and early bowel function recovery.Part II:Analyze of short-term outcomes of total laparoscopic right hemicolectomy with 3-step stapled intracorporeal isoperistaltic ileocolic anastomosis for colon cancerObjective:To evaluate the short-term outcomes,including post operative complications,of laparoscopic right hemicolectomy for colon cancer patients of both intracoporeal anastomosis and extracorporeal anastomosis methods.Method:We reviewed 56 patients who underwent total laparoscopic right hemicolectomy with 3-step stapled intracorporeal isoperistaltic ileocolicanastomosis and29 patients who underwent laparoscopic assisted right hemicolectomy with extracorporeal anastomosis.Compared the clinicopathological data,follow-up data and performed statistics analysis between two groups.Results:All 85 patients had no death.Post operative complications were 5 wound infection?5.88%?,1 obstruction?1.18%?,and 1 post-operative bleeding?1.18%?.There was no obvious difference in each subtype of complications between the groups.However,the overall complication rate was significantly lower in the TLG group as compared to that in the LG group?P=0.006?.Conclusion:Total laparoscopic right hemicolectomy with 3-step stapled intracorporeal anastomosis for colon cancer is a safe and reliable procedure with a satisfying short-term outcome and a lower complication rate.