Objective  To investigate the short-term clinical efficacy and complications of laparoscopic radical right hemicolectomy via the head-tail and medial approaches.

  Methods  Clinical data of 91 patients admitted for laparoscopic radical right hemicolectomy at Affiliated Hospital of Xuzhou Medical University between January 2015 and December 2019 were retrospectively analyzed. Of those patients, 50 and 41 patients underwent laparoscopic radical right hemicolectomy via the head-tail and medial approaches, respectively. According to the clinical indicators such as operation time, amount of intraoperative blood loss, rate of injury of Henle trunk and its branches (an indicator of conversion to laparotomy), number of lymph nodes dissected, number of positive lymph nodes, postoperative intestinal function recovery time, postoperative abdominal drainage tube removal time, postoperative hospitalization time, and postoperative complications, the potential advantages of laparoscopic radical right hemicolectomy via the head-tail approach were evaluated and analyzed.

  Results  The operation time was significantly shorter180 (150-188) min vs. 210 (180-255) min, P < 0.05, amount of intraoperative blood loss was significantly smaller50 (50-50) mL vs. 100 (50-100) mL, P < 0.05), and rates of injury of Henle trunk and its branches (0 case vs. 6 cases, P < 0.05) were significantly lower in the head-tail approach group than in the medial approach group. We found no statistically significant differences between the two groups with the conversion rate to laparotomy due to injuries of Henle trunk and its branches, number of lymph nodes dissected, number of positive lymph nodes, postoperative intestinal function recovery time, postoperative abdominal drainage tube removal time, postoperative hospitalization time, postoperative lymph leakage, and other complications (P>0.05).

  Conclusions  Compared with the commonly used medial approach in clinical practice, laparoscopic radical right hemicolectomy via the head-tail approach showed obvious improvement with respect to operative time, amount of intraoperative blood loss, and the injury rate of Henle trunk and its branches. Thus, the head-tail approach had higher operative safety and is thus worthy of further clinical application.