Medial versus lateral approache in laparscopic right hemicolectomy

Abstract

Background: Approach to right colon cancer is through open exploration but it has many complication, now laparoscopic right hemicolectomy is an advanced cancer surgery, laparoscopic right hemicolectomy can be done by medial or lateral or combined approach.Methods: This is prospective study carried out on 30 patients admitted to department of surgery in menufia university hospital from September 2016 to September 2018 and all cases have RT colon cancer; The patients are divided into three groups, 1- group A (n=10): underwent medial approach for laparscopic right hemicolectomy 2- group B (n=10): underwent lateral approach for laparscopic right hemicolectomy, 3- group C (n=10) : underwent combined laparscopic medial and lateral approach, Blood loss, operative time, operative and postoperative complication were assessed. The period of follow up is for 6 months.Results: Operative duration and blood loss were significantly lower in combined approach. Intra and post operative complications were low in combined and MA.Conclusions: Laparoscopic combined approach reduces the operative time and blood loss than MA and LA. Besides the oncologic advantages of an early vessel division and a "no-touch" dissection.

The tunnel versus medial versus lateral approach in laparoscopic right hemicolectomy in colon cancer: A retrospective study

“…Zhu et al, showed medial approach can significantly retrieve more lymph nodes contrary to the lateral approach 20 . Similar results were also seen in other studies by Elsisi et al, Le Voyer et al, and Chang et al [21][22][23] Table 3 shows that four patients had paralytic ileus postoperatively which was managed conservatively (P=0.9). Similarly, the other post-operative parameters were also comparable.…”