关键词: 结肠肿瘤, 腹腔镜手术, 手术入路, 完整结肠系膜切除

Abstract: The reasonable operative approach choice of lateral or medical approch for laparoscopic right hemicolectomy: Controversy and consensus        DU Xiao-hui,ZHANG Hong-liang.  Department of General Surgery, the First Affiliated Hospital, PLA General Hospital， Beijing 100853，China
Corresponding author: DU Xiao-hui，E-mail：duxiaohui301@
sina.com
Abstract    The key technologies of laparoscopic right hemicolectomy，such as anatomic mark and operative level，are becoming more and more mature. The scope of lymph node dissection and the way of digestive tract reconstruction are gradually standardized，and the concept of complete mesocolic excision is widely promoted.It is also of great significance to select the right surgical approach for standardizing the scope of lymph node dissection，finding the right anatomical plane and reducing the complications during the operation. The middle approach of laparoscopic radical right colon cancer radical resection has high tumor safety and convenient operation. The lateral approach is currently rarely used clinically, and is suitable for situations such as severe adhesions in the vascular region above the mesentery or inflammation of the local tissue caused by mesentery inflammation. The caudal approach not only meets the principle of total mesentery resection for colon cancer radical resection, but also is more simple and easy to perform than the middle approach. The head-to-tail approach is an improvement based on the caudal approach, which can reduce multiple turnovers of the omentum colon, and mesentery, and help shorten the learning curve for laparoscopic surgery. There are limited high-quality studies on the short- and long-term effects of different approaches to laparoscopic right hemicolectomy, and there is currently no conclusive conclusion on the best surgical approach.

Key words: colonic neoplasms, laparoscopic surgery, surgical approach, complete mesocolic excision