To explore the short-term outcomes of totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery in the surgical treatment of splenic flexure cancer.

We retrospectively collected the 23 patients diagnosed with splenic flexure cancer who underwent the totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery in National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital from January 2018 to January 2022. Baseline variables, surgical outcomes, pathological characteristics, postoperative recovery and complications were analyzed.

All patients have successfully undergone the totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery. The median operation time was 165 min. The median estimated blood loss was 40 mL and the median incisional length was 5.0 cm. With regard to pathological characteristics, the median length of tumor was 4.3 cm. The median proximal and distal resection margin was 13.2 cm and 12.1 cm, respectively. The median time to first ground activities, first oral intake, first flatus passage, first defecation, and postoperative hospital stay were 17.5 h, 12 h, 33.5 h, 55.5 h, 5 d, respectively. One patient suffered from the abdominal infection, which was controlled after antibiotic therapy. Other patients were not suffered from incisional infection, anastomotic leakage, abdominal bleeding or intestinal obstruction during the 30-day follow-up period.

Totally laparoscopic left hemicolectomy with overlapping delta-shaped anastomosis through the tunnel of terminal ileal mesentery could be applied in the surgical treatment of splenic flexure cancer with satisfactory short-term outcomes. But the long-term outcomes need to be explored.