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.
Cao et al. (Wed,) studied this question.