Objective To evaluate the feasibility and safety of laparoscopic right hemicolectomy after intestinal decompression through a small abdominal incision in the management of acute obstructive right-side colon carcinoma.Methods Twenty-two patients who underwent laparoscopic right hemicolectomy after ileal decompression through small abdominal incision due to acute obstructive right-side colon carcinoma(the study group)were retrospectively matched with thirty patients scheduled for a conventional open right hemicolectomy(the control group)during the same period from January 2017 to December 2022.The operation time,blood loss,number of dissected lymph node,the time of anal exhaust,the duration of hospitalization,postoperative complications and levels of serum inflammatory factors were compared between the two groups.Results There was no significant difference in clinic data between the two groups.Compared with the control group,the study group had less blood loss(t=-2.808,P=0.008)and faster anal exhaust time(t=-3.588,P=0.001),longer operation time(t=8.257,P=0.000).The number of dissected lymph nodes(t=-0.716,P=0.478),and the duration of hospitalization(t=-0.344,P=0.740)in the study group and the control group were with no significent difference.There was no significant difference in short-term postoperative complications(x2=1.292,P=0.256)between the study group(13.64％)and the control group(26.67％).The levels of IL-6(t=-l.101,P=0.277),TNF-α(t=1.088,P=0.283)and CRP(t=-1.191,P=0.202)in the study group and the control group before operation were with no significant difference.The levels of the above three indexes in the two groups were higher after surgery than before surgery,but the increase degree in the study group was lower than that in the control group.There were statistically significant differences in IL-6(t=-4.340,P＜0.001),TNF-α(t=-6.686,P＜0.001)and CRP(t=-5.930,P＜0.001)between the study group and the control group.Conclusion Laparoscopic right hemicolectomy after ileal decompression through a small abdominal incision in acute obstructive right-sided colon carcinoma is safe and feasible,it can effectively solve the problem of limited laparoscopic operating space,reduce bleeding,promote gastrointestinal function and reduce inflammatory reaction.
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