The feasibility and safety of complete laparoscopic extended right hemicolectomy with preserving the ileocecal junction in right-transverse colon cancer

Background: To evaluate the feasibility and safety of a new surgical method, complete laparoscopic extended right hemicolectomy with preserving the ileocecal junction in right-transverse colon cancer. Methods: : We retrospectively analyzed and compared the data of consecutive patients with right-transverse colon cancer who underwent complete laparoscopic extended right hemicolectomy with preserving the ileocecal junction ( n =23) and conventional complete laparoscopic extended right hemicolectomy ( n =34) in our hospital between October 2017 to May 2019, respectively. Results: : The overall operation time of the ileocecal junction-preserved group was significantly shorter than that of the control group ( p =0.024). There was no difference in the number of harvested lymph nodes, metastatic lymph nodes and rate of metastatic lymph nodes ( p ＞0.05). The ileocecal junction-preserved group showed shorter time of first flatus, lower frequency of postoperative diarrhea and shorter duration of postoperative hospitalization. Furthermore, it also showed that the defecation frequency was lower in the ileocecal junction-preserved group than control group on the 1 st , 3 rd and 6 th month ( p ＜0.05), and the number of patients who defecated at night or defecated four times or more a day were less in the ileocecal junction-preserved group than control group on the 1 st month ( p ＜0.05). Conclusion: The complete laparoscopic extended right hemicolectomy with preserving the ileocecal junction promises as a safe and feasible surgical procedure for right-transverse colon cancer, associated with earlier recovery of bowel function, shorter operation time and similar pathological outcomes when compared to the conventional laparoscopic procedure.