Left-sided colon cancer, Laparoscopic colon cancer radical resection, Priority dissecting of the inferior mesenteric artery, Complete medial approach, Splenic flexure mobilization, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

Abstract Purpose To explore the application effect of the technique of “priority dissecting of the inferior mesenteric artery combined with complete medial approach (IMA-CMA)” in laparoscopic left-sided colon cancer radical resection. Methods A total of 99 patients who underwent laparoscopic left-sided colon cancer radical resection with splenic flexure mobilization between September 2021 to May 2023 were included. Sixty-eight of these patients were analyzed after propensity score matching (PSM). The perioperative characteristics were compared. Results Among these enrolled patients, 45 underwent the traditional approach, and 54 underwent IMA-CMA approach. After PSM, the patients were matched to include 34 patients in each group, with no significant differences in the sex (p = 0.618) or location of tumor (p = 0.798) between the two groups. The patients in IMA-CMA group had shorter operating time (p = 0.032), less intraoperative blood loss (p = 0.003), a higher number of harvested lymph nodes (p = 0.044) and center group lymph nodes(p = 0.037), and a shorter postoperative hospital stay (p = 0.011). Number of positive lymph nodes and postoperative complications were not significantly different between the two groups. Conclusions The technique of IMA-CMA for splenic flexure mobilization is safe and feasible. It can reduce operating time, intraoperative blood loss and postoperative hospital stay, which is conducive to achieving a thorough D3 lymphadenectomy without increasing the incidence of perioperative complications.