title: [Comparison of cranial-to-caudal medial versus traditional medial approach in laparoscopic right hemicolectomy: a case-control study].
abstract: OBJECTIVE
  To compare the short-term efficacy of modified medial (M-M) with traditional medial(T-M) approach in laparoscopic right hemicolectomy(LRHC)/or extended laparoscopic right hemicolectomy(ELRHC) for right or hepatic flexure colon cancer.
  
  
  METHODS
  A comparative, retrospective study was performed that included all the patients scheduled for LRHC or ELRHC for right or hepatic flexure colon cancer between June 2013 and August 2014. The following factors of two groups were assessed: patient characteristics, operative details, pathology, and surgical outcomes.
  
  
  RESULTS
  A total of 99 patients were evaluated, including 52 patients in the M-M group and 47 patients in the T-M group. Age, gender, body mass index, American Society of Anesthesiology(ASA) class, tumor location, diameter of tumor were not significantly different between the two groups. As compared to the T-M group, M-M group was associated with a significantly shorter operative time [(105.6±38.8) min vs. (138.2±39.5) min, P<0.05], less estimated mean blood loss[(38.4±12.4) ml vs. (87.2±24.6) ml, P<0.05] and lower intraoperative vascular damage rate [5.8%(3/52) vs. 25.5%(12/47), P<0.05]. There were no significant differences between these two groups in terms of intraoperative complications, CME, conversion rate, number of harvested lymph node, postoperative ileus, hospital stay, wound, lung and urinary system infections.
  
  
  CONCLUSIONS
  The use of M-M approach in laparoscopic right hemicolectomy provides short-term benefits in operative time and estimated blood loss compared with traditional medial approach.
authors: Department of General Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China. wanghe@fmmu.edu.cn.
authors: Bobo
authors: B
authors: Zheng
authors: Nan
authors: N
authors: Wang
authors: Tao
authors: T
authors: Wu
authors: Qing
authors: Q
authors: Qiao
authors: Shuai
authors: S
authors: Zhou
authors: Bo
authors: B
authors: Zhang
authors: Ying
authors: Y
authors: Yang
authors: Shuang
authors: S
authors: Xie
authors: Ke
authors: K
authors: Wang
authors: Xianli
authors: X
authors: He
mesh_terms: D016022:Case-Control Studies; D003082:Colectomy; D044682:Colon, Ascending; D003110:Colonic Neoplasms; D006801:Humans; D045823:Ileus; D007431:Intraoperative Complications; D010535:Laparoscopy; D007902:Length of Stay; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies