Kết quả phẫu thuật nội soi cắt đại tràng phải, nạo vét hạch D3 điều trị ung thư biểu mô đại tràng phải tại Bệnh viện Hữu nghị Việt Đức từ 01/2018 đến 12/2023

Colorectal cancer remains a significant global health challenge, ranking among the top cancers in incidence and mortality, with right-sided colon adenocarcinoma showing an increasing trend, particularly in Asian countries. Effective surgical management, including laparoscopic right hemicolectomy with meticulous D3 lymphadenectomy, is crucial not only for definitive treatment but also for accurate pathological staging and prognosis. While laparoscopic surgery is a standard approach, the technical complexity of achieving a comprehensive D3 lymphadenectomy presents a considerable challenge. This study aims to evaluate the surgical and oncological outcomes of this advanced procedure for right-sided colon adenocarcinoma at a major university hospital, providing valuable insights into its safety and efficacy in a real-world setting.

Colorectal surgeons, surgical oncologists, general surgeons, medical residents, and researchers specializing in gastrointestinal surgery and oncology.

This retrospective descriptive study investigated the outcomes of laparoscopic right hemicolectomy with D3 lymphadenectomy in 45 patients diagnosed with right-sided colon adenocarcinoma at Viet Duc University Hospital between January 2018 and December 2023. Data analysis was performed using SPSS 22.0. The patient cohort had a mean age of 62.2 ± 12.5 years with a male predominance, and tumor location was primarily in the right colon (88.9%). Key findings revealed a mean operative time of 171.1 ± 46.9 minutes, a short mean postoperative hospital stay of 7.0 ± 3.1 days, and notably, no cases of anastomotic leakage. Pathological examination showed a high rate of T3-T4 tumor invasion (91.1%) and nodal metastasis (51.1%), with an adequate mean lymph node yield of 20.9 ± 4.7 nodes. Kaplan-Meier survival analysis highlighted the critical role of tumor stage in prognosis, demonstrating 5-year overall survival rates of 94.1% for stage II and 72.7% for stage III disease (p=0.047). Similarly, survival varied significantly with nodal status (N0: 94.7%, N1: 75%, N2: 66.7%, p=0.047). The study concludes that laparoscopic right hemicolectomy with D3 lymphadenectomy is a safe and effective treatment approach, yielding favorable short-term outcomes, low complication rates, and sufficient lymph node harvest for accurate staging. Tumor stage, particularly nodal status, remains a paramount prognostic factor influencing long-term survival after surgery. These findings underscore the value of comprehensive D3 lymphadenectomy in the management of right-sided colon adenocarcinoma.