Lin L, Yuan SB, Guo H. Does cranial-medial mixed dominant approach have a unique advantage for laparoscopic right hemicolectomy with complete mesocolic excision? World J Gastrointest Surg 2022; 14(3): 221-235 [PMID: 35432765 DOI: 10.4240/wjgs.v14.i3.221]
Corresponding Author of This Article
Si-Bo Yuan, MM, Chief Doctor, Department of Gastrointestinal Surgery and Xiamen City Key Laboratory of Gastrointestinal Cancer, Zhongshan Hospital, Xiamen University, No. 201 Hubin South Road, Xiamen 361000, Fujian Province, China. yuansb8627860592@sina.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2022; 14(3): 221-235 Published online Mar 27, 2022. doi: 10.4240/wjgs.v14.i3.221
Does cranial-medial mixed dominant approach have a unique advantage for laparoscopic right hemicolectomy with complete mesocolic excision?
Li Lin, Si-Bo Yuan, Huan Guo
Li Lin, Si-Bo Yuan, Huan Guo, Department of Gastrointestinal Surgery and Xiamen City Key Laboratory of Gastrointestinal Cancer, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian Province, China
Author contributions: Lin L and Yuan SB designed, performed the research study, contributed new reagents and analytic tools and wrote the manuscript; Lin L and Guo H analyzed the data; all authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the scientific research sub-committee of the medical ethics committee Institutional Review Board of Zhongshan Hospital Affiliatedto Xiamen University (Approval No. xmzsyyky-2021-159).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflict of interest.
Data sharing statement: The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Si-Bo Yuan, MM, Chief Doctor, Department of Gastrointestinal Surgery and Xiamen City Key Laboratory of Gastrointestinal Cancer, Zhongshan Hospital, Xiamen University, No. 201 Hubin South Road, Xiamen 361000, Fujian Province, China. yuansb8627860592@sina.cn
Received: September 1, 2021 Peer-review started: September 1, 2021 First decision: November 7, 2021 Revised: November 14, 2021 Accepted: March 5, 2022 Article in press: March 5, 2022 Published online: March 27, 2022 Processing time: 204 Days and 23.4 Hours
Abstract
BACKGROUND
Complete mesocolic excision (CME) with central vascular ligation (CVL) was proposed by Hohenberger in 2009. The CME principle has gradually become the technical standard for colon cancer surgery. How to achieve CME with CVL in laparoscopic right hemicolectomy (LRH) is controversial, and a unified standard approach is not yet available. In recent years, the authors’ team has integrated the theory of membrane anatomy, tried to combine the cephalic approach with the classic medial approach (MA) for technical optimization, and proposed a cranial-medial mixed dominant approach (CMA).
AIM
To explore the feasibility of operational approaches for LRH with CME.
METHODS
In this retrospective cohort study, the clinical data of 57 patients with right-sided colon cancer (TNM stage I, II, or III) who underwent LRH with CME from January 2016 to June 2020 were collected and summarized. There were 31 patients in the traditional MA group and 26 in the CMA group.
RESULTS
There were no significant differences in baseline data between the two groups. The operation was shorter and the number of lymph nodes dissected was higher in the CMA group than in the MA group, but there was no significant difference in the number of positive lymph nodes, intraoperative blood loss, postoperative exhaust time, feeding time, postoperative hospital stay or postoperative complication incidence.
CONCLUSION
Our study shows that the CMA is a safe and feasible procedure for LRH with CME and has a unique advantage.
Core Tip: This work presents the combination of the cranial approach and the classic medial approach and optimization of the combined approach to propose a cranial-medial mixed dominant approach (CMA) based on embryonic development and membrane anatomy. Our study shows that the CMA is a safe and feasible procedure for laparoscopic right hemicolectomy with complete mesocolic excision and has a unique advantage.
