Inferior versus medial approach in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer: A propensity‐score‐matched analysis.

Aim: In laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer, either an inferior approach (IA) or a medial approach (MA) is selected in our institution based on the surgeon's preference. The present study compared the treatment outcomes between IA and MA. Method: This retrospective, single‐centre study using propensity score matching analysed the short‐ and long‐term outcomes of laparoscopic surgery in patients with right‐sided colon cancer from 2010 to 2019 at Cancer Institute Hospital. Results: After patient selection, 1011 patients remained for the analysis, of which 67% underwent IA surgery and 33% underwent MA surgery. After propensity score matching (1:1), 325 patients in each group were analysed. Regarding the short‐term outcomes, there were no significant differences in the operation time, rate of conversion to open surgery or postoperative complication rate (Clavien–Dindo Grade ≥ III) between the two groups, although the intra‐operative median blood loss was significantly less in the IA group than in the MA group (IA, 13 ml vs. MA, 20 ml, P < 0.0001). Regarding the long‐term outcomes, the relapse‐free survival, liver‐relapse‐free survival, cancer‐specific survival and overall survival were all similar between groups. Conclusion: Both the IA and MA in laparoscopic colectomy with complete mesocolic excision and D3 lymphadenectomy for right‐sided colon cancer are safe and feasible approaches; the IA may have an advantage over the MA in terms of reduced intra‐operative blood loss. Based on their similar oncological outcomes, either the IA or MA can be selected, based on one's preference. [ABSTRACT FROM AUTHOR]