Laparoscopic ileocecal-sparing vs traditional right hemicolectomy for cancer of the hepatic flexure or proximal transverse colon:a dual-center propensity score-matched study  

作　　者：Jinjie He Yue Cao Xiangxing Kong Siqi Dai Jun Li Dong Xu Yongmao Song Jianwei Wang Lifeng Sun Zhanhuai Wang Qian Xiao Lei Ding Lihao Chen Cheng Lei Jian Wang Haijiang Wang Kefeng Ding 

机构地区：[1]Department of Colorectal Surgery and Oncology(Key Laboratory of Cancer Prevention and Intervention,China National Ministry of Education),The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang,P.R.China [2]Center for Medical Research and Innovation in Digestive System Tumors,Ministry of Education,Hangzhou,Zhejiang,P.R.China [3]Department of Gastrointestinal Surgery,The 3rd Affiliated Teaching Hospital of Xinjiang Medical University(Affiliated Tumor Hospital),Urumqi,Xinjiang Uyghur Autonomous Region,P.R.China [4]Zhejiang Provincial Clinical Research Center for Cancer,Hangzhou,Zhejiang,P.R.China

出　　处：《Gastroenterology Report》2024年第1期243-250,共8页胃肠病学报道(英文)

基　　金：supported by the Fundamental Research Funds for the Central Universities[grant number 226-2022-00009];the National Natural Science Foundation of China[grant numbers 82072624,11932017,and 82103684];the Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China[grant number LHDMY22C060002];the Project of the Regional Diagnosis and Treatment Center of the Health Planning Committee[grant number JBZX-201903].

摘　　要：Background:Traditional right hemicolectomy(TRH)is the standard treatment for patients with nonmetastatic right colon cancer.However,the ileocecum,a vital organ with mechanical and immune functions,is removed in these patients regardless of the tumor location.This study aimed to evaluate the technical and oncological safety of laparoscopic ileocecal-sparing right hemicolec-tomy(LISH).Method:Patients who underwent LISH at two tertiary medical centers were matched 1:2 with patients who underwent TRH by pro-pensity score matching based on sex,age,body mass index,tumor location,and disease stage.Data on surgical and perioperative outcomes were collected.Oncological safety was evaluated in a specimen-oriented manner.Lymph nodes(LNs)near the ileocolic ar-tery(ICA)were examined independently in the LISH group.Disease outcomes were recorded for patients who completed one year of follow-up.Results:In all,34 patients in the LISH group and 68 patients in the TRH group were matched.LISH added 8 minutes to the dissection of LNs around the ileocolic vessels(groups 201/201d,202,and 203 LNs),without affecting the total operation time,blood loss,or peri-operative adverse event rate.Compared with TRH,LISH had a comparable lymphadenectomy quality,specimen quality,and safety margin while preserving a more functional bowel.The LISH group had no cases of LN metastasis near the ICA.No difference was detected in the recurrence rate at the 1-year follow-up time point between the two groups.Conclusion:In this dual-center study,LISH presented comparable surgical and oncological safety for patients with hepatic flexure or proximal transverse colon cancer.

关 键 词：right colon cancer ileocecal sparing HEMICOLECTOMY safety short-term outcome 

分 类 号：R73[医药卫生—肿瘤]