Application effects of different surgical approaches in laparoscopic left hemicolectomy for colon cancer

GENG Xuan; ZHANG Minkang; ZHANG Wentao; SONG Tao

doi:10.3969/j.issn.1002-3429.2025.21.006

Abstract：Objective To compare the application effect of three surgical approaches,medial,lateral and lesser sac in laparoscopic left colectomy for colon cancer.Methods Clinical data of 102 patients admitted to our hospital for laparoscopic left colectomy for colon cancer from January 2020 to January 2022 were retrospectively analyzed,and they were divided into medial group(n=30),lateral group(n=23)and lesser sac group(n=49)according to different surgical approaches.The intraoperative and postoperative conditions,and survival of the three groups were compared.Results The intraoperative blood loss in the medial group was less than that in the lateral group and the lesser sac group(P<0.01),the laparoscopic dissection time in the lesser sac group was significantly shorter than that in the medial group and the lateral group(P<0.01),and the number of cases entering the posterior pancreatic space in the lesser sac group was significantly less than that in the medial group and the lateral group(P<0.01).There was no significant difference in postoperative hospital stay,time to first flatus,and complication rate among the three groups(P>0.05),nor in survival rate among the medial group[89.66%(3/29)],the lateral group[95.65%(1/23)],and the lesser sac group[80.95%(8/42)](P>0.05)during the follow-up period.Conclusion For laparoscopic left colectomy for colon cancer,medial,lateral and lesser sac are equally effective,and the intraoperative blood loss is less via the medial approach,while the lesser sac approach can effectively shorten the laparoscopic dissection time and avoid entering the retropancreatic space.The surgical approach can be selected according to the actual intraoperative conditions and doctors'experience,ensuring safety during laparoscopic left colectomy for colon cancer.