Published online Mar 27, 2022. doi: 10.4240/wjgs.v14.i3.221
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
Complete mesocolic excision (CME) with central vascular ligation (CVL) is the technical standard for colon cancer surgery. How to achieve CME with CVL in laparoscopic right hemicolectomy (LRH) is controversial. Several approaches have been proposed, but a unified standard approach is not yet available.
The authors' team has proposed and practised the cranial-medial mixed dominant approach (CMA) to perform LRH with CME for years. We would like to confirm that the CMA does have unique technical advantages through data rather than subjective opinionssby comparing it with the classic medial approach (MA).
To compare the CMA with the classic MA to prove that the CMA has unique advantages in performing LRH.
We compared the two groups (CMA and MA) by intraoperative data (operative duration, blood loss, specimen length, number of resected and positive lymph nodes, and postoperative data (exhaust time, liquid intake time, postoperative hospitalization, postoperative complications). Additionally, we described the procedure and technical points of the CMA in detail to facilitate the reader's understanding.
There were no significant differences in baseline data or the number of positive lymph nodes, intraoperative blood loss, postoperative exhaust time, feeding time, postoperative hospital stay or postoperative complication incidence between the two groups. The operation was shorter and the number of lymph nodes dissected was higher in the CMA group.
The CMA weakens the vascular and lymphoid anatomy and has unique advantages for LRH with CME and CVL.
More RCT-based evidence and further multicentre prospective studies are needed to validate the CMA.