Clinical application of laparoscopic radical resection of left-sided colon cancer via posterior mesocolon of transverse colon combined with central vascular ligation approach
Objective To explore the clinical value of laparoscopic radical resection of left-sided colon cancer via the posteri-or mesocolon of the transverse colon combined with the central vascular ligation approach.Methods A retrospective anal-ysis was conducted on the clinical data of 43 patients who underwent laparoscopic radical resection of left-sided colon canc-er via the posterior mesocolon of the transverse colon combined with the central vascular ligation approach(combined ap-proach group)at the Second People's Hospital of Yi'nan County,and 62 patients who underwent laparoscopic"central vas-cular ligation""four-step"mobilization of the splenic flexure for radical resection of left-sided colon cancer(central ap-proach group)at the Gastrointestinal Surgery Department of Linyi People's Hospital,both from March 1,2018,to March 1,2023.The preoperative general information,intraoperative and postoperative pathological data,and postoperative prognosis indicators of the two groups were statistically analyzed and compared using SPSS 22.0.Results No severe complications or deaths occurred in either group.The operative time in the combined approach group(136.74±6.80)min was significantly shorter than that in the central approach group(190.73±14.17)min,with a statistically significant difference,P＜0.01.The intraoperative blood loss in the combined approach group(36.16±5.33)ml was significantly less than that in the central approach group(84.52±7.88)ml,also with a statistically significant difference,P＜0.05.The total number of lymph nodes obtained in the combined approach group[22.00(20.00,22.00)]was significantly higher than that in the central approach group[19.25(18.00,22.00)],showing a statistically significant difference,P＜0.01.The postoperative hospital stay in the combined approach group[7.00(7.00,9.20)days]was significantly shorter than that in the central approach group[9.00(8.00,9.00)days],with a statistically significant difference,P＜0.01.The difference in the incidence of intraoperative accidents(including splenic hemorrhage and accessory injuries to sur-rounding organs)between the two groups was statistically significant,P=0.033.Although the number of positive lymph nodes retrieved in the combined approach group(1.72±1.14)was slightly higher than that in the central approach group(1.35±0.96),this difference was statistically significant,P＞0.05.The incidence of intraoperative accidents in the com-bined approach group(2.33％)was significantly lower than that in the central approach group(17.74％).There were no statistically significant differences between the two groups in terms of postoperative first flatus time,time to initiate liquid diet,and postoperative complication rates,all P＞0.05.Conclusions Laparoscopic radical resection of left-sided colon cancer via the posterior mesocolon of the transverse colon combined with the central vascular ligation approach results in shorter operative time,less intraoperative blood loss,retrieval of a higher number of lymph nodes,shortened hospital stay,and improved safety,making it worthy of clinical promotion and application.
left-sided colon cancerposterior mesocolon of transverse coloncentral vascular ligationlymph nodes
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