Chen H, Han DP, Xiong JY, Li ZS, Hu TC, Li ZR, Cao Y. Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon. World J Gastrointest Surg 2025; 17(10): 109395 [PMID: 41178863 DOI: 10.4240/wjgs.v17.i10.109395]
Corresponding Author of This Article
Yi Cao, Associate Chief Physician, Department of General Surgery, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Zheng Street, Nanchang 330006, Jiangxi Province, China. ndyfy04150@ncu.edu.cn
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Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 27, 2025 (publication date) through Nov 15, 2025
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World Journal of Gastrointestinal Surgery
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1948-9366
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Chen H, Han DP, Xiong JY, Li ZS, Hu TC, Li ZR, Cao Y. Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon. World J Gastrointest Surg 2025; 17(10): 109395 [PMID: 41178863 DOI: 10.4240/wjgs.v17.i10.109395]
World J Gastrointest Surg. Oct 27, 2025; 17(10): 109395 Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109395
Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
Hao Chen, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao, Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Dong-Ping Han, Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
Co-first authors: Hao Chen and Dong-Ping Han.
Author contributions: Chen H, Han DP, Xiong JY, Li ZS, Hu TC and Cao Y designed the study; Chen H, Xiong JY, Li ZS gathered the data; Chen H, Hu TC and Cao Y drafted the paper; Li ZR provided some case numbers for this study; all authors critically revised the manuscript and approved the final version for publication.
Supported by Jiangxi Provincial Natural Science Foundation of China, No. 20224BAB206063.
Institutional review board statement: The Ethics Committee of the First Affiliated Hospital of Nanchang University approved the ethical approval of this study.
Informed consent statement: The Institutional Review Board of the First Affiliated Hospital of Nanchang University waived the requirement for informed consent because of the retrospective nature of the study.
Conflict-of-interest statement: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Cao, Associate Chief Physician, Department of General Surgery, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Zheng Street, Nanchang 330006, Jiangxi Province, China. ndyfy04150@ncu.edu.cn
Received: May 9, 2025 Revised: July 10, 2025 Accepted: September 4, 2025 Published online: October 27, 2025 Processing time: 168 Days and 12.5 Hours
Abstract
BACKGROUND
The advantages and disadvantages of various surgical procedures for radical dissection of left hemicolonic malignancies are controversial. We aimed to determine which procedures are best for patients with different characteristics. The focus of this study was to investigate the safety and clinical efficacy of three different surgical procedures, namely, robotic-assisted surgery (RAS), hand-assisted laparoscopic surgery (HALS) and conventional laparoscopic surgery (CLS), for the dissection of malignant tumors of the left hemicolon and the effect of these procedures on long-term prognosis.
AIM
To determine which procedures are best for patients with malignant tumors of the left hemicolon and the safety and clinical efficacy of three different surgical procedures.
METHODS
A retrospective analysis of the clinical data of 224 patients with left hemicolonic malignancies admitted to the Department of General Surgery of the First Affiliated Hospital of Nanchang University from June 2015 to June 2024 was conducted. Patient data were analyzed to determine tumor stage, duration of surgery, number of lymph nodes cleared, incidence and severity of postoperative complications, amount of intraoperative bleeding, overall survival (OS), and progression-free survival.
RESULTS
The short-term postoperative outcomes after RAS, HALS and CLS were compared. The leukocyte and absolute neutrophil counts on postoperative day 4 were highest after RAS, followed by CLS and then HALS, and the differences were statistically significant (P < 0.05). The length of postoperative hospital stay was highest after CLS, followed by RAS and then HALS, and the differences were statistically significant (P < 0.05). The postoperative recovery time of gastrointestinal function was shortest after HALS, followed by RAS and CLS, which had equal values, and the differences were statistically significant (P < 0.05). Hospitalization costs were highest among patients who underwent RAS, followed by CLS and then HALS, and the differences were statistically significant (P < 0.05). The OS among patients who underwent HALS, CLS, and RAS did not significantly differ (P = 0.384).
CONCLUSION
There were no significant differences between procedures in the number of lymph nodes cleared or OS, and all procedures successfully achieved radical dissection of the malignant tumors. HALS had lower hospitalization costs and shorter postoperative recovery time of gastrointestinal function, and CLS performed between HALS and RAS. Different surgical procedures have varying impacts on the length of postoperative hospital stay and the degree of postoperative inflammation, so selection should be individualized to each patient.
Core Tip: This study investigates the safety, short-term efficacy and long-term prognosis of different surgical approaches by comparing three surgical approaches for malignant tumors of the left hemicolon. The result is that various surgical procedures have different advantages, and thus individualized surgical procedures should be selected for different patients. This will serve as a reference for clinical practice.
