Objective To investigate the application value of intracorporeal stapler and handsewn anastomosis in laparoscopic extended radical left hemicolectomy.
Methods The retros-pective and descriptive study was conducted. The clinical data of 38 patients who underwent laparos-copic extended radical left hemicolectomy at Henan Provincial People′s Hospital from December 2018 to May 2024 were collected. There were 22 males and 16 females, aged 66 (range, 28-81) years. All patients underwent lymph node dissection and complete mesocolic excision. Gastrointestinal anastomosis was performed using combined stapled and handsewn end-to-end anastomosis. Obser-vation indicators: (1) surgical and postoperative recovery; (2) results of postoperative pathological examination; (3) follow‑up. Measurement data with skewed distribution were represented as M(range), and count data were represented as absolute numbers.
Results (1) Surgical and postoperative recovery: all 38 patients completed laparoscopic extended radical left hemicolectomy successfully, with no conversion to open surgery. The operation time of the 38 patients was 110 (range, 90-230) minutes, the intracorporeal anastomosis time was 15 (range, 10-30) minutes, the volume of intraoperative blood loss was 50 (rang, 10-130) mL, the time to postoperative first flatus was 2 (range, 1-3) days, and the postoperative complications included 2 cases of incision infection, 1 case of pulmonary infection, and 1 case of adhesive intestinal obstruction, all of which were cured by conservative treatment. The duration of postoperative hospital stay was 7 (range, 5-17) days. (2) Results of postoperative histopathological examination: the number of lymph node dissected in 38 patients was 21 (range, 14-27), the length of the surgical resection specimen was 35 (range, 30-50) cm, and the margins were all negative. Pathological T staging included 2 cases of T2 stage, 32 cases of T3 stage, 4 cases of T4 stage, pathological N staging included 3 cases of N0 stage, 15 cases of N1 stage,20 cases of N2 stage. All 38 patients were classified as M0 stage. There were 7 patients with deficient mismatch repair protein (MMR) expression, and 31 patients with normal MMR protein expression. (3) Follow-up: 38 patients were followed up for 47 (range, 22-84) months after surgery. During the follow‑up, 26 patients had no metastasis or recurrence, 12 patients had tumor metastasis, among which 3 cases died and 9 cases survived with tumor.
Conclusion Intracorporeal stapler and handsewn anastomosis in laparoscopic extended radical left hemicolectomy is safe and feasible, with satisfactory short‑term efficacy.
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