Abstract
BACKGROUND: The optimal anastomotic technique for total laparoscopic right hemicolectomy remains a subject of debate. Novel intracorporeal approaches may help overcome current challenges. AIM: To compare the efficacy of improved π anastomosis and overlap anastomosis. METHODS: A retrospective analysis was conducted on 110 colon cancer patients who underwent total laparoscopic radical right hemicolectomy at the Department of Gastrointestinal Surgery, Suzhou Ninth People's Hospital, from January 2022 to May 2024. All patients underwent intracorporeal reconstruction, with 42 patients receiving improved π anastomosis and 68 patients undergoing overlap anastomosis. The perioperative related indicators and postoperative complications were compared between the two groups of patients. RESULTS: No significant differences were observed between the two groups in terms of operative time, number of lymph nodes dissected, or postoperative hospital stay (P > 0.05). However, the anastomosis time was significantly shorter in the improved π anastomosis group (P < 0.001), while the time to first anal flatus was longer (P < 0.05). No cases of anastomotic leakage or stenosis occurred in either group, though one patient in the overlap group experienced anastomotic bleeding (hematochezia). During a follow-up period of over six months, no local recurrence or distant metastasis was detected. The learning curve analysis shows that both groups demonstrated good model fit, and improved π anastomosis achieves proficiency earlier than overlap anastomosis. CONCLUSION: The improved π anastomosis in total laparoscopic radical right hemicolectomy ensures high safety and favorable short-term outcomes. It offers a shorter learning curve and quicker proficiency compared to overlap anastomosis, reducing operative times and technical demands on surgeons.