The Cranial-caudal Mixed Medial Approach for Laparoscopic Right Hemicolectomy
Condition: Intraoperative Blood Loss; Postoperative Complications; Pathology
MeSH terms: Postoperative Complications
Study type: Interventional

Summary: 
      To explore the feasibility and effectiveness of the cranial-caudal mixed medial approach in
      laparoscopic right hemicolectomy with complete mesocolic excision. Laparoscopic right
      hemicolectomy using the cranial-caudal mixed medial approach is safe and feasible, can
      shorten the operation time, reduce the risk of intraoperative bleeding, and has good clinical
      results.
    

Detailed description: 
      The data of patients undergoing laparoscopic right hemicolectomy performed in the same
      surgical group of gastrointestinal surgery at Northern Jiangsu People's Hospital from
      February 2017 to June 2022 were retrospectively analyzed. According to different surgical
      approaches, patients were divided into the cranial-caudal mixed medial approach group and the
      medial approach group.

      Intraoperative and postoperative data were collected. Intraoperative data is obtained through
      surgical records and pathological reports, including total operation time, Laparoscopic
      procedure time, Intraoperative blood loss, sample length, number of lymph nodes collected,
      and number of positive lymph nodes. Postoperative data includes exhaust time, liquid intake
      time, postoperative hospitalization and complications. Among them, complications are
      short-term postoperative complications (surgical related complications, non-surgical related
      complications) within the first 30 days after surgery (or throughout the hospitalization
      period, if more than 30 days, and are classified according to the Clavien-Dindo
      classification method.

      To explore the feasibility and effectiveness of the cranial-caudal mixed medial approach in
      laparoscopic right hemicolectomy with complete mesocolic excision.
    

Intervention name(s): The cranial-caudal mixed medial approach
Intervention type(s): Procedure
Intervention description(s): Expose the fusion fascia of Transverse colon mesocolon and stomach, and cut the gastrocolic ligament. The mesentery of Transverse colon was dissociated from the medial side to the lateral side along the gastroepiploic vessels to expose the branches of Henle's trunk and the right colon vessels. The dorsal mesentery of the small intestine is cut along the "yellow white line", and free cephalically along the Toldt space to separate the posterior space of the Ascending colon and the anterior space of the pancreas and duodenum behind the Transverse colon. The right colon blood vessels were dissected along SMV from the projection of ileocolic blood vessels, and the blood vessels were cut off by high ligation, and the lymph nodes at the root of Mesentery were cleared. Through a small incision in the middle of the abdomen, the right colon and mesentery were completely removed to complete digestive tract reconstruction.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment