Comparison Of Clinical Effects Of Laparoscopic D3 Radical Arteriovenous Approach For Right Colon Cancer

ObjectiveBy analyzing the factors related to the two methods of laparoscopic D3 radical arteriovenous approach for right colon cancer,the advantages and disadvantages of the two methods were compared,so as to provide a reference for clinical surgeons to choose a more appropriate surgical method for the treatment of patients with right colon cancer.MethodsRetrospective analysis was performed on the patients who visited Liaoning Provincial People’s Hospital between December 1,2015 and December 1,2020 and were diagnosed as malignant tumor of the right hemisphere of the colon and underwent laparoscopic D3 radical resection of the right hemisphere of the colon.Through strict inclusion criteria and exclusion criteria for screening,the research objects that meet the requirements of this experiment were selected.Laparoscopic D3 radical resection was performed for the right colon cancer,following the CME principle.All patients were divided into the experimental group and the control group.The left superior mesenteric artery was used as the medial boundary and the lymph nodes within this boundary were dissected in the experimental group,while the left superior mesenteric vein was used as the medial boundary and the lymph nodes within this boundary were dissected in the control group.Collection two groups of patients with preoperative,intraoperative and postoperative three aspects,a total of 16 observation indexes data,including patient’s age,sex,body mass index,tumor site,tumor preoperative clinical staging,operation time,intraoperative blood loss,postoperative exhaust time,postoperative drainage tube removal time for the first time,postoperative drainage tube drainage liquid volume,The total number of dissected lymph nodes,the total number of positive lymph nodes,the proportion of positive lymph nodes on arterial surface,chylous leakage,diarrhea and total postoperative complications.Through the statistical analysis of these 16 related factors,the differences between the experimental group and the control group were analyzed,so as to compare the advantages and disadvantages of the two methods of laparoscopic D3 radical resection of right colon cancer and select a more appropriate surgical method.ResultsA total of 43 subjects were collected in this study: 20 in the experimental group and 23 in the control group.The general data and clinical data of the two groups,such as age,gender,body mass index,tumor site and preoperative clinical stage,were statistically analyzed,and the differences were not statistically significant(P>0.05).There were no significant differences between the two groups in operative time,intraoperative blood loss,postoperative first exhaust time,postoperative drainage tube removal time,postoperative total amount of fluid drained from drainage tube,total number of positive lymph nodes,chylous leakage,diarrhea and total postoperative complications(P<0.05).The total number of lymph nodes in the experimental group was higher than that in the control group,and the difference between the two groups was statistically significant(21.00 vs 16.00,P<0.05).ConclusionIn D3 laparoscopic radical resection of right colon cancer,more lymph nodes were dissected with the left superior mesenteric artery as the dissected boundary in accordance with the CME principle,which is a feasible surgical method.However,no positive lymph nodes were detected on the surface of the artery,and chylous leakage and diarrhea occurred in the patients after surgery.Therefore,in the selection of surgical methods,patients’ physical conditions and imaging findings should be taken into consideration comprehensively,and patients suspected of having positive lymph nodes on the surface of the superior mesenteric artery should be selected for this surgical method.