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Fifty-four patients underwent colectomy using the multidirectional approach; among these, 20 underwent the DMA and 34 underwent the caudal-first multidirectional approach (CMA). Sixty-six patients underwent the conventional medial approach. Complications within 30\u00a0days of surgery were compared between the groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>There were 54 patients in the multidirectional group [29 females, median age 72\u00a0years (range 36\u201391\u00a0years)] and 66 in the medial group [42 females, median age 72\u00a0years (range 41\u201391\u00a0years)]. Total operative time was significantly shorter in multidirectional approach patients than conventional medial approach patients (208\u00a0min vs. 271\u00a0min; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and significantly shorter in patients who underwent the DMA compared to the CMA (201\u00a0min vs. 269\u00a0min; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Operative time for the mobilization procedure was also significantly shorter in patients who underwent the DMA (131\u00a0min vs. 181\u00a0min; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Blood loss and incidence of postoperative complications did not differ. In 77 patients with advanced T3\/T4 tumors, the DMA, CMA, and conventional medial approach were performed in 13, 21, and 43 patients, respectively. Total operative time and operative time of the mobilization procedure were significantly shorter in patients undergoing DMA. Blood loss and incidence of postoperative complications did not differ. R0 resection was achieved in all patients with advanced tumors.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The DMA in laparoscopic right colectomy is safe and feasible and can achieve R0 resection with a shorter operative time than the conventional medial approach, even in patients with advanced tumors.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10151-021-02444-5","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T16:03:00Z","timestamp":1620921780000},"page":"865-874","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Securing the surgical field for mobilization of right-sided colon cancer using the duodenum-first multidirectional approach in laparoscopic surgery"],"prefix":"10.1007","volume":"25","author":[{"given":"K.","family":"Nagayoshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Nagai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. 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Approval was granted by the Kyushu University Hospital Human Research Ethics Committee (No. 29-292). Informed consent was obtained in the form of an opt-out on the web site; patients who declined to participate were excluded. We thank Jane Charbonneau, DVM and Matthew Wetzel, MD from Edanz Group () for editing a draft of this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained in the form of opt-out on the web-site.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed conscent"}}]}}