Laparoscopic ileocecal-sparing vs traditional right hemicolectomy for cancer of the hepatic flexure or proximal transverse colon:a dual-center propensity score-matched study
Jinjie He1
Yue Cao1
Xiangxing Kong1
Siqi Dai1
Jun Li1
Dong Xu1
Yongmao Song1
Jianwei Wang1
Lifeng Sun1
Zhanhuai Wang1
Qian Xiao1
Lei Ding1
Lihao Chen1
Cheng Lei2
Jian Wang1
Haijiang Wang2
Kefeng Ding3
1.Department of Colorectal Surgery and Oncology(Key Laboratory of Cancer Prevention and Intervention,China National Ministry of Education),The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang,P.R.China2.Department of Gastrointestinal Surgery,The 3rd Affiliated Teaching Hospital of Xinjiang Medical University(Affiliated Tumor Hospital),Urumqi,Xinjiang Uyghur Autonomous Region,P.R.China3.Center for Medical Research and Innovation in Digestive System Tumors,Ministry of Education,Hangzhou,Zhejiang,P.R.China;Zhejiang Provincial Clinical Research Center for Cancer,Hangzhou,Zhejiang,P.R.China
摘要：Background:Traditional right hemicolectomy(TRH)is the standard treatment for patients with nonmetastatic right colon cancer.However,the ileocecum,a vital organ with mechanical and immune functions,is removed in these patients regardless of the tumor location.This study aimed to evaluate the technical and oncological safety of laparoscopic ileocecal-sparing right hemicolec-tomy(LISH).
Method:Patients who underwent LISH at two tertiary medical centers were matched 1:2 with patients who underwent TRH by pro-pensity score matching based on sex,age,body mass index,tumor location,and disease stage.Data on surgical and perioperative outcomes were collected.Oncological safety was evaluated in a specimen-oriented manner.Lymph nodes(LNs)near the ileocolic ar-tery(ICA)were examined independently in the LISH group.Disease outcomes were recorded for patients who completed one year of follow-up.
Results:In all,34 patients in the LISH group and 68 patients in the TRH group were matched.LISH added 8 minutes to the dissection of LNs around the ileocolic vessels(groups 201/201d,202,and 203 LNs),without affecting the total operation time,blood loss,or peri-operative adverse event rate.Compared with TRH,LISH had a comparable lymphadenectomy quality,specimen quality,and safety margin while preserving a more functional bowel.The LISH group had no cases of LN metastasis near the ICA.No difference was detected in the recurrence rate at the 1-year follow-up time point between the two groups.
Conclusion:In this dual-center study,LISH presented comparable surgical and oncological safety for patients with hepatic flexure or proximal transverse colon cancer.
机标关键词：rightcancerstudycolondual-centerflexurehemicolectomyhepatic
论文发表日期：2024-08-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：8( 325-332 )
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