腹腔镜辅助右半结肠癌扩大根治术清扫SMA表面淋巴结的安全性研究OACSTPCD

Objectives To investigate the safety of laparoscopic-assisted extended radical resection for right colon cancer with dissection of lymph nodes on the surface of the superior mesenteric artery(SMA).Methods A total of 167 pa-tients who underwent laparoscopic-assisted extended radical resection for right colon cancer performed by the same lead surgeon in the First Affiliated Hospital of Naval Medical University from January 2019 to August 2023 were included in the study.Based on propensity score matching,patients were divided into the SMA group(n=30)and the superior mes-enteric vein(SMV)group(n=104)at a ratio of 1:4,with the left side of the SMA and the left side of the SMV as the medial boundary of lymph node dissection.After matching,intraoperative conditions,postoperative conditions,and postop-erative pathology indicators were compared between the two groups.Results There were no significant differences in in-traoperative blood loss,total amount of postoperative abdominal drainage fluid,postoperative hospital stay,first postopera-tive defecation time,postoperative complications,tumor location,tumor size,degree of differentiation,T stage,and N stage between the two groups(P＞0.05).The total number of dissected lymph nodes,the total number of positive lymph nodes,the proportion of patients with dissected lymph nodes in group 6 were higher in the SMA group than in the SMV group(P＜0.05).There were 3 patients with positive lymph nodes in group 6.Three patients in the SMA group showed positive lymph nodes on the surface of the SMA.Conclusion In laparoscopic-assisted extended radical resection for right colon cancer,taking the left side of SMA as the medial boundary of lymph node dissection can harvest more lymph nodes and eliminate potentially metastatic lymph nodes on the surface of SMA,without significantly increasing in-traoperative blood loss and the incidence of postoperative complications.