# Comparing cranial-caudal-medial and medial–lateral approaches for laparoscopic right hemicolectomy: a propensity score-matched analysis

## TL;DR

This study compares two surgical approaches for right hemicolectomy and finds that the cranial-caudal-medial approach offers faster surgery and better outcomes.

## Contribution

The study evaluates the safety and efficacy of a newer surgical approach for right hemicolectomy using a propensity score-matched analysis.

## Key findings

- The cranial-caudal-medial approach reduced operation time and blood loss compared to the medial–lateral approach.
- The cranial-caudal-medial approach resulted in more harvested lymph nodes and non-inferior survival rates.
- Both approaches showed similar safety and long-term oncological outcomes.

## Abstract

The cranial-caudal-medial approach (CCMA) has been proposed for laparoscopic right hemicolectomy nowadays. This study aimed to investigate the safety and oncological efficacy of CCMA in the treatment of right-sided colon cancer compared to the medial–lateral approach (MLA).

Patients diagnosed with right-sided colon cancer were included from February 2015 to June 2018, retrospectively, dividing into the CCMA group and the MLA group. We compared the basic characteristics and the short-term and long-term outcomes in two groups.

Two hundred and ninety-six patients were included in this study. The baseline characteristics were similar in two groups. Compared with MLA group, CCMA group exhibited shorter operation time (136.3 ± 25.3 min vs. 151.6 ± 21.5 min, P < 0.001), lower estimated blood loss (44.1 ± 15.2 ml vs. 51.4 ± 26.9 min, P = 0.010), and more harvested lymph nodes (18.5 ± 7.1 vs. 16.5 ± 5.7, P = 0.021). The 5-year overall survival (OS) rate for the CCMA group was 76.5%, and the 5-year disease-free survival (DFS) rate was 72.3%, both of which were not inferior to the MLA group. No significant difference was found between two groups in terms of other clinical parameters.

The CCMA in laparoscopic right hemicolectomy is safe and feasible, making the anatomical plane clearer. This approach can shorten the operation time, reduce intraoperative blood loss, harvest more lymph nodes, and yield satisfactory oncological outcomes.

The online version contains supplementary material available at 10.1186/s12957-024-03465-8.