关键词: 腹腔镜, 右半结肠癌根治术, 尾内侧入路, 中间入路, 中间翻页式清扫

Abstract: Objective To explore the application value of medial caudal approach combined with middle page-turning lymphadenectomy in laparoscopic radical right hemicolectomy. Methods Eighty-six patients with right hemicolon cancer admitted to our hospital from May 2019 to May 2020 were selected as the research objects,and they were divided into an observation group of 43 cases and a control group of 43 cases by random drawing.The control group adopts the intermediate approach,and the observation group adopts the medial caudal approach combined with middle page-turning lymphadenectomy.The surgical recovery index,complication rate,serum tumor markers and survival index were compared between the two groups to evaluate the clinical efficacy and safety. Results There were no significant differences between the two groups in the number of lymph nodes removed,the length of the intestinal tube removed,extubation,fluid feeding and hospitalization time,the incidence of postoperative complications (P>0.05),but the operation time and intraoperative bleeding in the observation group were significantly lower,and the postoperative exhaust time was shorter (P<0.05).The serum CA19-9 and CEA levels of the two groups after one year decreased， and the serum CA19-9 and CEA levels of the observation group were lower than those of the control group (P<0.05).The disease-free progression period was prolonged in the observation group (P<0.05),but there was no difference in survival time. Conclusion The medial caudal approach combined with the middle page-turning lymphadenectomy has higher clinical application value in the laparoscopic radical right hemicolectomy,which is conducive to shortening the operation time and postoperative exhaust time,reducing the amount of intraoperative bleeding and postoperative serum CA19-9 and CEA levels,and improving the disease-free progression period with high safety.

Key words: laparoscopy, radical right hemicolectomy, medial caudal approach, intermediate approach, middle page-turning lymphadenectomy