Impact of Cephalo-medial Approach versus Conventional Medial Approach on Tumor Markers in Patients Undergoing Laparoscopic Radical Resection for Rectal Cancer

The choice of surgical approach in laparoscopic radical resection for rectal cancer (RC) is known to directly affect oncological radicality and functional preservation. The cephalo-medial approach, as an emerging technique, still requires evidence-based validation of its clinical value. The perioperative impacts of the cephalo-medial approach were compared with those of the conventional medial approach in laparoscopic radical resection for RC. 124 patients with RC were divided into the cephalo-medial group (AG, n = 62) and the conventional medial group (BG, n = 62). The primary observational indicators included: (1) operative parameters: operation duration, number of harvested lymph nodes, etc.; (2) tumor markers; (3) gastrointestinal recovery indices: time to bowel sounds recovery, time to first oral intake, and time to first flatus; (4) postoperative complications. Visible superiority was observed in the AG for operation duration ( P= 0.001), intraoperative bleeding (IOB) ( P < 0.001), number of harvested lymph nodes ( P= 0.005), and mesorectal integrity ( P= 0.002); carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels were markedly decreased at 1 month postoperatively ( P < 0.001); Faster gastrointestinal recovery was achieved (time to bowel sounds recovery P= 0.001; time to first oral intake P < 0.001), and a lower incidence of urinary dysfunction was recorded ( P= 0.042). Laparoscopic radical resection via the cephalo-medial approach demonstrates visible advantages in operative efficiency, oncological radicality, and functional preservation, and it is recommended as the preferred procedure for patients.