Safety and feasibility of robot-assisted left hemicolectomy for colon cancer

doi:10.3969/j.issn.1674-8115.2026.08.015

Abstract

Abstract:

Objective ·To evaluate the safety and feasibility of robot-assisted left hemicolectomy for colon cancer (R-LCC) in patients with left-sided colon cancer requiring left colic flexure mobilization. Methods ·A total of 105 patients with colon cancer who underwent R-LCC in the Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanchang University, between September 2015 and June 2023 were retrospectively enrolled. Clinical and pathological data of all patients were collected. The incidence of postoperative complications was analyzed, and postoperative prognostic follow-up was conducted for all patients. Results ·Among the 105 patients with colon cancer who underwent R-LCC, one patient converted to open surgery due to intraoperative bleeding. The median operative time was 165 min. All patients achieved R0 resection, with no cases of positive resection margins. The ulcerative type was the most common gross tumor type, accounting for 69.5% of all cases. The maximum tumor diameter was (4.67±1.97) cm. The total number of harvested lymph nodes was 14 (1‒42), and the number of metastatic lymph nodes was 0 (0‒13). The overall incidence of postoperative complications within 30 d was 16.2%. Surgical site infection was the most common postoperative complication, with an incidence rate of 6.7%. The 1- and 3-year cumulative survival rates were 91.4% and 85.1%, respectively. Conclusion ·Patients undergoing R-LCC with left colic flexure mobilization have a low incidence of intraoperative complications and favorable survival outcomes. These findings confirm that robotic surgery is safe and feasible for this procedure.

Key words: robot, colon cancer, perioperative period, safety

CLC Number:

R735.35

Chen Hao, Hu Tengcheng, Zhou Liqiang, Wang Guosen, Deng Wensheng, Li Zhensheng, Xiong Jianyang, Li Zhengrong, Cao Yi. Safety and feasibility of robot-assisted left hemicolectomy for colon cancer[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2026,(8): 1143-1148.

Figures/Tables 4

TrendMD

References 18

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Index	Total (n=105)
Age/year	59.6±14.2
Gender/n(%)
Male	72 (68.6)
Female	33 (31.4)
Comorbidity/n(%)	40 (38.1)
Hypertension	26 (24.8)
Diabetes	6 (5.7)
Hepatitis	2 (1.9)
Cerebral infarction	1 (1.0)
Coronary heart disease	1 (1.0)
Multiple complications	4 (3.8)
History of abdominal surgery/n(%)	21 (20.0)
Appendectomy	6 (5.7)
Cholecystectomy	6 (5.7)
Hysterectomy	3 (2.9)
Splenectomy	1 (1.0)
Nephrectomy	2 (1.9)
Laparoscopic inguinal hernia repair	3 (2.9)

Index	Total (n=105)
Age/year	59.6±14.2
Gender/n(%)
Male	72 (68.6)
Female	33 (31.4)
Comorbidity/n(%)	40 (38.1)
Hypertension	26 (24.8)
Diabetes	6 (5.7)
Hepatitis	2 (1.9)
Cerebral infarction	1 (1.0)
Coronary heart disease	1 (1.0)
Multiple complications	4 (3.8)
History of abdominal surgery/n(%)	21 (20.0)
Appendectomy	6 (5.7)
Cholecystectomy	6 (5.7)
Hysterectomy	3 (2.9)
Splenectomy	1 (1.0)
Nephrectomy	2 (1.9)
Laparoscopic inguinal hernia repair	3 (2.9)

Index	Total (n=105)
Postoperative intestinal function recovery time/d	2 (1‒7)
Time to first oral liquid intake/d	2 (1‒50)
Postoperative hospital stay/d	8 (5‒63)
Postoperative chemotherapy/n(%)
Yes	67 (63.8)
No	38 (36.2)
Postoperative complication/n(%)	17 (16.2)
Small bowel obstruction	3 (2.9)
Postoperative bleeding	2 (1.9)
Anastomotic leakage	2 (1.9)
Surgical site infection	7 (6.7)
Postsurgical gastroparesis syndrome	1 (1.0)
Postoperative pancreatic fistula	1 (1.0)
Postoperative pneumonia	1 (1.0)

Index	Total (n=105)
Postoperative intestinal function recovery time/d	2 (1‒7)
Time to first oral liquid intake/d	2 (1‒50)
Postoperative hospital stay/d	8 (5‒63)
Postoperative chemotherapy/n(%)
Yes	67 (63.8)
No	38 (36.2)
Postoperative complication/n(%)	17 (16.2)
Small bowel obstruction	3 (2.9)
Postoperative bleeding	2 (1.9)
Anastomotic leakage	2 (1.9)
Surgical site infection	7 (6.7)
Postsurgical gastroparesis syndrome	1 (1.0)
Postoperative pancreatic fistula	1 (1.0)
Postoperative pneumonia	1 (1.0)

Index	Left colic flexure adjacent group (n=33)	Non-left colic flexure adjacent group (n=72)	P value
Tumor diameter/cm	4.9±1.6	4.6±2.1	0.488
Intraoperative complication/n(%)			0.138
Yes	1 (3.0)	0 (0)
No	32 (97.0)	72 (100.0)
Operative time/min	165 (100‒330)	168 (80‒300)	0.738
Intraoperative blood loss/mL	50 (10‒1 200)	50 (10‒400)	0.530
Histological type/n(%)			0.697
Ulcerative	24 (72.7)	49 (68.1)
Uplifted	9 (27.3)	23 (31.9)
Tumor stage/n(%)			0.096
Ⅰ	2 (6.1)	13 (18.0)
Ⅱ	20 (60.6)	29 (40.3)
Ⅲ	11 (33.3)	30 (41.7)
Number of lymph nodes cleared/n	13 (6‒42)	15 (1‒41)	0.285
Number of metastatic lymph nodes/n	0 (0‒9)	0 (0‒13)	0.714
Postoperative intestinal function recovery time/d	2 (1‒4)	2 (1‒7)	0.480
Time to first oral liquid intake/d	2 (1‒15)	2 (1‒50)	0.851
Postoperative hospital stay/d	8 (6‒20)	10 (5‒63)	0.952
Postoperative chemotherapy/n(%)			0.395
Yes	23 (69.7)	44 (61.1)
No	10 (30.3)	28 (38.9)
Postoperative complication/n(%)			0.130
Yes	8 (24.2)	9 (12.5)
No	25 (75.8)	63 (87.5)