Overview
The goal of this clinical trial is to compare the long-term outcomes of Laparoscopic Ileocecal-Sparing Right Hemicolectomy(LISH) compared to traditional laparoscopic right hemicolectomy(TRH) in the treatment of hepatic flexure colon cancer and proximal transverse colon cancer.
Description
This study is a prospective, multicenter, open-labeled, randomized controlled clinical trial. The enrolled patients will be randomly assigned to either the LISH or TRH group in a 1:1 ratio and will receive the corresponding surgery. The primary endpoint: 3-year disease free survival. The second endpoint: (1)90-day postoperative complications; (2)Pathology-related indicators, including positive margin rate, number of harvested lymph nodes and lymph node metastasis rate;(3) 5-year overall survival rate (OS)
Eligibility
Inclusion Criteria:
- Age between 18-75 years old
- ASA classification ≤III
- Colon adenocarcinoma confirmed by endoscopy and pathological biopsy
- Enhanced abdominal CT indicating the primary lesion is located in the hepatic flexure of the colon or proximal transverse colon (proximal 1/3 of the transverse colon)
- Preoperative clinical staging: TanyNanyM0
- Patients able to understand the study protocol, willing to participate in the research, and providing written informed consent
Exclusion Criteria:
- Preoperative examination indicates synchronous multiple primary colorectal cancers or other diseases requiring bowel segment resection
- Preoperative imaging or intraoperative exploration reveals: 1) tumor involving surrounding organs requiring combined organ resection; 2) presence of distant metastasis; 3) inability to perform R0 resection; 4) fused and fixed lymph nodes at the root of the ileocolic vessels
- Additional radical surgery following Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) procedures
- History of any other malignant tumor within the last 5 years or familial adenomatous polyposis, except for cured in situ cervical cancer, basal cell carcinoma, papillary thyroid carcinoma, or skin squamous cell carcinoma
- Presence of bowel obstruction, bowel perforation, or intestinal bleeding requiring emergency surgery
- Patients unsuitable for or unable to tolerate laparoscopic surgery
- Pregnant or lactating women
- Patients with a history of psychiatric disorders
- Patients who have received neoadjuvant therapy prior to surgery
- Patients deemed unsuitable for the study by MDT discussion
- Patients unable to understand the study's conditions and objectives, and refusing to sign informed consent.