To analyze the feasibility, safety and short-term efficacy of laparoscopic right colon cancer radical resection transrectal specimen extraction without abdominal incision.

The clinical data of laparoscopic right colon cancer radical resection transrectal specimen extraction without abdominal incision (CRC-NOSES-Ⅷ type B) and laparoscopy-assisted radical right hemicolectomy were collected from January 2018 to April 2021 in Cancer Hospital/Chinese Academy of Medical Sciences. Retrospectively analyze the influence of the two operation methods on postoperative recovery, complications and pathological results of patients.

A total of 15 patients completed operation CRC-NOSES-Ⅷ type B, which was set as the experimental group. A total of 45 male patients with laparoscopic-assisted radical right hemicolectomy in the same period who met the inclusion criteria were randomly selected as the control group. There were no significant differences in gender, age, American Society of Anesthesiologists (ASA), laboratory examination, preoperative tumor size, location and clinical TNM stage between the experimental group and the control group (P＞0.05). The difference in body mass index (BMI) between the experimental group and the control group was statistically significant (t=-2.401, P=0.022). All patients in the experimental group and control group completed the operation successfully, and no patients were transferred to open surgery. There were no significant differences in operative time, intraoperative blood loss, intestinal function recovery time, postoperative hospital stay, postoperative pathological tumor maximum diameter, lymph node detection and positive number, pathological type of tumor, degree of differentiation and postoperative TNM stage between the two groups(P＞0.05). The pain scores on the first day and the third day after surgery were significantly different between the experimental group and the control group (t=-6.477, 10.160; P＜0.05). No postoperative complications such as intestinal obstruction, abdominal bleeding, abdominal infection, anastomotic leakage, anastomotic bleeding, anastomotic stenosis, rectal incision bleeding, rectal incision fistula were found in the experimental group, and the fecal control function of the whole group was not significantly affected.

BMI has important value and reference significance in the selection of CRC-NOSES-Ⅷ B and laparoscopy-assisted radical right hemicolectomy. The short-term efficacy of CRC-NOSES-Ⅷ B method in the selected and suitable patients with right colon cancer is similar to that of the traditional laparoscopic assisted radical resection of right colon cancer. The surgical technique is safe and feasible, the pain of patients is significantly reduced, and the postoperative satisfaction is significantly increased.