Wu JZ, Liu PF, Gu ZG, Zhang Z, Zhou ZY, Shen T. Application of improved π anastomosis in totally laparoscopic radical right hemicolectomy. World J Gastrointest Surg 2026; 18(2): 115978 [DOI: 10.4240/wjgs.v18.i2.115978]
Corresponding Author of This Article
Tao Shen, MD, Department of Gastrointestinal Surgery, Suzhou Ninth Hospital Affiliated to Soochow University (Suzhou Ninth People’s Hospital), No. 2666 Ludang Road, Wujiang District, Suzhou 215200, Jiangsu Province, China. szjyshentao@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
Jian-Zhong Wu, Peng-Fei Liu, Zhi-Gang Gu, Zhi Zhang, Zheng-Yu Zhou, Tao Shen, Department of Gastrointestinal Surgery, Suzhou Ninth Hospital Affiliated to Soochow University (Suzhou Ninth People’s Hospital), Suzhou 215200, Jiangsu Province, China
Author contributions: Wu JZ was responsible for data collection, statistical analysis, serving as the lead surgeon, and drafting the manuscript; Liu PF, Gu ZG, Zhang Z, and Zhou ZY contributed to the revision and optimization of the article; Shen T designed the study, was responsible for the final review and validation of the manuscript; and all authors read and approved the final version of the manuscript.
Supported by the Soochow University, No. 24QL200116; Suzhou Science and Education for Health General Program, No. MSXM2024066; and Suzhou Ninth People’s Hospital for Science and Technology Project, No. YK202533.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Suzhou Ninth People’s Hospital, approval No. 2021-19.
Informed consent statement: Due to the retrospective and de-identified nature of this study, written informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Tao Shen, MD, Department of Gastrointestinal Surgery, Suzhou Ninth Hospital Affiliated to Soochow University (Suzhou Ninth People’s Hospital), No. 2666 Ludang Road, Wujiang District, Suzhou 215200, Jiangsu Province, China. szjyshentao@163.com
Received: October 31, 2025 Revised: November 27, 2025 Accepted: January 7, 2026 Published online: February 27, 2026 Processing time: 119 Days and 1.7 Hours
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.
Core Tip: A retrospective analysis was conducted on 110 colon cancer patients who underwent total laparoscopic radical right hemicolectomy. This study compares the efficacy of improved π anastomosis and overlap anastomosis. No significant differences were observed between the two groups in terms of operative time, number of lymph nodes dissected, or postoperative hospital stay, however, the anastomosis time was significantly shorter in the improved π anastomosis group. The learning curve analysis shows that improved π anastomosis achieves proficiency earlier than overlap anastomosis.
