Short-term Outcomes of Robotic Left Colectomy Reconstructed by Intracorporeal Overlap Anastomosis for Left-sided Colon Cancer: A Single-center Report from Japan.

Background/aim: Surgery for colon cancer requires covering a wide area and performing both tumor resection and precise lymph node dissection. Robotic left-sided colectomy (RLC) has not been thoroughly established due to the rarity of descending colon cancer. Therefore, we investigated 19 patients who underwent RLC for left-sided colon cancer.

Patients and methods: Between January 2023 and July 2024, a total of 19 consecutive patients underwent robotic radical left colectomy, which included mobilization of the splenic flexure. We compared the intra- and postoperative factors between left-sided colectomy with and without stent placement.

Results: Total operative time (p=0.002), console time (p=0.001), and lymph node harvest time (p=0.001) were significantly different. The total operative time with stent placement was longer than that without stent placement (421.6 vs. 302.0, p<0.01). Console time with stent placement was longer than that without stent placement (315.0 vs. 202.0, p<0.01). More lymph nodes were harvested with stent placement than without (33.1 vs. 11.0, p<0.01).

Conclusion: We did not experience any conversions to open surgery, and two Grade II complications were observed according to the Clavien-Dindo classification. Both total operative and console times were longer in cases with stent placement compared to those without. Nevertheless, we safely performed robotic left colectomy, regardless of whether the left-sided colon cancer was treated with stent placement, even in cases where the anastomosis overlapped naturally. Our postoperative outcomes showed no anastomosis-related complications. Therefore, RLC reconstruction using an intracorporeal overlap anastomosis is feasible for left-sided colon cancer, both in terms of intraoperative and postoperative outcomes.