To study and compare the effects of medial approach, dorsal approach and dorsal-medial hybrid approach in complete mesocolic excision (CME) on perioperative and postoperative cumulative survival of patients with laparoscopic right hemicolectomy.

96 patients undergoing laparoscopic right hemicolectomy with CME in Zhaoqing First People’s Hospital from February 2016 to July 2019 were prospectively single-blind selected. The patients were randomly divided into three groups, with 32 cases in each group: medial group (medial approach), dorsal group (dorsal approach) and hybrid group (dorsal-medial hybrid approach). The perioperative indexes and complication rates of the three groups were compared, and the postoperative cumulative disease-free survival rate (DFS) and overall survival rate (OS) were analyzed by Kaplan-Meier curve.

Three cases in the medial group and one case in the dorsal group were converted to laparotomy respectively. The operation time and intraoperative bleeding volume of dorsal group and hybrid group were better than those of the medial group, and the hybrid group was better than that of dorsal group (P<0.05). The anal exhaust time, drainage tube extraction time and postoperative hospital stay, the total incidence of complications in the hybrid group were significantly less than those in the other groups (all P<0.05). There were no significant differences in postoperative cumulative OS and DFS among the three groups (χ²=0.227, 0.714, P=0.893, 0.700).

Dorsal-medial hybrid approach during laparoscopic right hemicolectomy with CME has more advantages in shortening operation time, reducing intraoperative blood loss, and reducing the incidence of complications, which is beneficial to postoperative rehabilitation and worthy of clinical promotion.