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Priority Management of Henle Trunk in Cranial-to-Caudal Approach for Laparoscopic Right Hemicolon Cancer Surgery
Yao Yang1,2, Xiaohua Jiang1,2, Zhuqing Zhou1,2
1Department of Colorectal Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Insights
Prioritizing the Henle trunk in laparoscopic right hemicolectomy (LRH) for right colon cancer significantly reduces blood loss, operation time, and vascular injury. This approach is safe and feasible, offering improved short-term clinical efficacy compared to traditional methods.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic right hemicolectomy (LRH) is a standard procedure for right colon cancer.
- Optimizing surgical techniques, such as Henle trunk management, is crucial for improving patient outcomes.
- Comparing different approaches to Henle trunk management can identify more effective surgical strategies.
Purpose of the Study:
- To compare the short-term clinical efficacy of a prior approach versus a traditional approach to Henle trunk management in laparoscopic right hemicolectomy (LRH) for right colon cancer.
- To evaluate the impact of Henle trunk management on operative parameters and patient recovery.
- To determine the safety and feasibility of the priority management of Henle trunk in LRH.
Main Methods:
- Retrospective analysis of 161 patients who underwent LRH for right colon cancer between June 2018 and December 2020.
- Patients were divided into two groups: priority management of Henle trunk (82 patients) and traditional approach (79 patients).
- Demographics, clinicopathological characteristics, operative data, and postoperative outcomes were recorded and compared.
Main Results:
- The priority group showed significantly reduced mean blood loss (73.84 ± 17.31 mL vs. 83.42 ± 30.16 mL; P = 0.001).
- Operation time was markedly shorter in the priority group (151.35 ± 6.75 min vs. 159.13 ± 18.85 min; P = 0.014).
- Intraoperative vascular injury rate was significantly lower in the priority group (6.1% vs. 17.7%; P = 0.022).
- No significant differences were observed in postoperative complications, recovery times, or pathological findings.
Conclusions:
- Priority management of the Henle trunk in LRH for right colon cancer is a safe and feasible procedure.
- This approach leads to less blood loss, shorter operation times, and a lower intraoperative vascular injury rate.
- The findings suggest improved short-term clinical efficacy with the priority Henle trunk management strategy.
Abstract:
This study aimed to compare the short-term clinical efficacy between prior and traditional approach of Henle trunk in laparoscopic right hemicolectomy (LRH) for right colon cancer. A total of 161 patients underwent LRH for right colon cancer between June 2018 and December 2020 by the same group of physicians. The prior approach of Henle trunk (priority group) was used in 82 patients and traditional approach in 79 (traditional group). The demographics and clinicopathological characteristics were recorded and retrospectively analyzed. As compared to the traditional group, the mean blood loss reduced significantly [73.84 ± 17.31 mL vs. 83.42 ± 30.16 mL; P = 0.001], the operation time was markedly shorter [151.35 ± 6.75 min vs. 159.13 ± 18.85 min; P = 0.014], and the intraoperative vascular injury rate was significantly lower [6.1% (5/82). vs. 17.7% (14/79); P = 0.022]. There were no significant differences in the postoperative complications, first exhaust time, first defecation time, drainage time, postoperative hospital stay, quality evaluation of surgical specimens and pathological findings between two groups. Our study shows that the priority management of Henle trunk in the LRH for right colon cancer is a safe and feasible procedure with less blood loss, shorter operation time and lower intraoperative vascular injury rate.
