Comparison of the mixed approach and medial approach in laparoscopic right hemicolectomy for right colon cancer: a retrospective study.

[PURPOSE] The study aimed to determine the 3-year disease-free survival (DFS) and overall survival (OS) outcomes of the mixed approach vs. the medial approach in laparoscopic right hemicolectomy.

[METHODS] This retrospective study analyzed clinical data from 290 patients who underwent laparoscopic right hemicolectomies at our institution. Based on the surgical approach used, the patients were categorized into a medial approach group ( = 144) or a mixed approach group ( = 146). The primary endpoint was the 3-year DFS rate and the secondary endpoint was the 3-year OS. To minimize confounding, propensity score matching was performed based on six key variables.

[RESULTS] No significant difference was found in the baseline data between the two groups. Moreover, the results showed no significant difference between the medial approach and mixed approach groups in both DFS [HR = 1.799, 95% CI (0.9673, 3.347),  > 0.05] and OS [HR = 1.274, 95% CI (0.5521, 2.940),  > 0.05], regardless of tumor stage. Multivariate analyses demonstrated that tumor location and chemotherapy completion were independent prognostic factors for DFS.

[CONCLUSIONS] Across tumor stages, 3-year DFS and OS rates were similar between the two surgical approach groups. Thus, considering its safety and efficacy, the mixed approach may be a preferred alternative.