The tunnel approach versus medial approach in laparoscopic radical right hemicolectomy for colon cancer: A retrospective cohort study
Background: Although Multiple studies showed that the median approach is nowadays the most widely accepted approach according to the "no-touch" principle and safety. However, this approach is a demanding procedure with a steep learning curve and has a high rate of conversion to laparotomy. This aim is to explore the feasibility and safety of tunnel approach in laparoscopic radical right hemicolectomy for colon cancer.Methods:From July 2016 to October 2018, a total of 106 consecutive patients
... ecutive patients with colon cancer who were subjected to the laparoscopic radical right hemicolectomy in the affiliated cancer hospital of zhengzhou university were enrolled. The patients underwent either tunnel approach (TA) (n=56) or traditional medial approach (MA) (n=50) according to the surgical maneuver performed. The patients' baseline demographics and perioperative results were compared between the two groups.Results: The baseline characteristics did not differ between groups. The blood loss was significantly less [20.0(5.0-40.0) vs. 100(50.0-150.0) , p < 0.001] and operation time was significantly shorter [128.4±16.7 vs. 145.6±20.3min, p < 0.001]in the TA group than those in MA group. Time to first flatus and postoperative hospital stay were similar [3.0(2.0-4.0) vs. 3.0(3-4.0)d,p=0.329; 10.4±2.6 vs. 10.7±3.0d,p=0.506] in both groups. The conversion to laparotomy and complication rates were similar between the groups(0 vs. 6.0%, p = 0.203; 14.3% vs. 18.0%, p =0.603,respectively). There was no treatment-related death in both groups.Conclusions: The tunnel approach in laparoscopic radical right hemicolectomy for colon cancer is a technically feasible and safe procedure as a preferable approach at present compared to those of medial approach, meanwhile this method is easier for beginners to master. Hence this tunnel approach right hemicolectomy is worth recommended.