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Updated: May 30, 2026
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Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
[Hand-assisted laparoscopic versus laparoscopic-assisted right hemicolectomy: a clinical controlled study]
Hui-zhong Qiu1, Lai Xu, Bei-zhan Niu
1Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China. qiuhzpumc@yahoo.com.cn
Summary
Hand-assisted laparoscopic surgery (HALS) and laparoscopic surgery (LAS) offer comparable oncologic outcomes for right hemicolectomy. Both methods demonstrate similar minimal invasiveness, with HALS showing potential cost benefits and comparable recovery metrics.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic techniques have revolutionized colectomy, offering minimally invasive options.
- Comparing hand-assisted laparoscopic surgery (HALS) with conventional laparoscopic surgery (LAS) is crucial for optimizing patient outcomes and resource utilization.
Purpose of the Study:
- To compare the clinical outcomes, safety, and oncologic efficacy of right hemicolectomy performed using HALS versus LAS.
- To evaluate differences in postoperative recovery, complications, and medical expenses between HALS and LAS.
Main Methods:
- A retrospective study of 95 patients undergoing right hemicolectomy, with 47 in the HALS group and 48 in the LAS group.
- Comparison of intraoperative parameters, postoperative recovery, complications, oncologic results, medical expenses, and follow-up data between the two surgical approaches.
- All procedures were performed by the same surgical team to minimize variability.
Main Results:
- No severe complications or perioperative deaths were observed in either group.
- Significant differences were noted in intraoperative bleeding, operative time, and incision length (P<0.05).
- HALS demonstrated significantly lower medical expenses (P<0.05) and a comparable 3-year disease-free survival rate (91.3% vs. 87.9%, P>0.05) to LAS, despite retrieving fewer lymph nodes (18.2 vs. 24.1, P<0.05).
Conclusions:
- Both HALS and LAS provide similar minimally invasive benefits and oncologic outcomes for right hemicolectomy.
- HALS presents a cost-effective alternative with comparable patient recovery and oncologic safety to LAS.
