Comparison of complete laparoscopic versus laparoscopic-assisted right hemicolectomy based on enhanced recovery after surgery concepts for right-sided colon cancer

[Objectives] To compare the efficacy of complete laparoscopic right hemicolectomy and laparoscopic-assisted right hemicolectomy based on the concept of enhanced recovery after surgery in right-sided colon cancer. [Methods] A retrospective analysis was conducted on the clinical data of 65 patients who underwent right hemicolectomy at the Affiliated Hospital of Jiangsu University from December 2018 to December 2021. Patients were divided into the complete laparoscopic group (undergoing complete laparoscopic right hemicolectomy, n=35) and the laparoscopic-assisted group (undergoing laparoscopic-assisted right hemicolectomy, n=30) based on different surgical methods. The surgical-related indicators (operation time, intraoperative blood loss, lymph node yield, time to postoperative first flatus, oral intake initiation, hospital stay), postoperative incision pain degree (assessed by visual analogue scale), the occurrence of complications (incision infection, anastomotic leakage, pulmonary infection, deep vein thrombosis), patient satisfaction, postoperative follow-up, and survival were compared between the two groups. [Results] The complete laparoscopic group demonstrated less intraoperative blood loss, shorter time to first flatus, earlier oral intake, and reduced hospital stay (P<0.05). No differences existed in operative time or lymph node yield (P>0.05). The incision pain scores on the first and third days after surgery in the complete laparoscopic group were lower than those in the laparoscopy-assisted group, and the incision pain scores on the third day after surgery in both groups were lower than those on the first day (P<0.05). The total complication rate in the complete laparoscopic group was lower than that in the laparoscopy-assisted group, and the difference was statistically significant (P<0.05). The patient satisfaction rate in the complete laparoscopic group was higher than that in the laparoscopy-assisted group (P<0.05). During the 3-year postoperative follow-up, 2 patients were lost to follow-up. During the follow-up period, 3 cases of liver metastasis, 3 cases of lung metastasis, and 1 case of pelvic recurrence occurred in the complete laparoscopic group; 4 cases of liver metastasis and 2 cases of lung metastasis occurred in the laparoscopy-assisted group. There was no statistically significant difference in the postoperative recurrence and metastasis rate between the two groups (P>0.05). The 3-year overall survival rates of patients in the complete laparoscopic group and the laparoscopy-assisted group were 70.6% (24/34) and 75.9% (22/29), respectively, and there was no statistically significant difference (χ2=2.000，P=0.157). [Conclusion] Complete laparoscopic right hemicolectomy based on the concept of enhanced recovery after surgery is safe and effective, with advantages such as mild postoperative pain, rapid recovery of gastrointestinal function, short hospital stay, low total complication rate, and high patient satisfaction.