Effectiveness and safety of self-pulling and latter transection reconstruction in totally laparoscopic left hemicolectomy: a retrospective cohort study

Left hemicolectomy is the standard surgical procedure for the treatment of left-sided colon cancer. laparoscopy-assisted left hemicolectomy (LALH) combined with extracorporeal anastomosis (EA) is currently the preferred approach. However, performing total laparoscopic left hemicolectomy (TLLH) with intracorporeal anastomosis (IA) is technically challenging. This retrospective cohort study collected data from 178 patients diagnosed with left-sided colon cancer who underwent either totally laparoscopic left hemicolectomy utilizing self-pulling and latter transection(SPLT-TLLH) or LALH surgery at the First Affiliated Hospital of Chongqing Medical University between July 1, 2022, and June 30, 2025. Using propensity score matching, we compared and analyzed the perioperative parameters and short-term clinical outcomes between the two patient groups. In total, 178 patients with left-sided colon cancer who underwent SPLT-TLLH ( n = 45) or LALH ( n = 133) were enrolled. The results indicated that the operative time was significantly shorter in the SPLT-TLLH group than that in the LALH group. Additionally, the SPLT-TLLH group demonstrated lower intraoperative blood loss, a greater distal resection margin, a smaller incision size ( P < 0.001),and a faster recovery of intestinal function ( P < 0.05) compared to the LALH group. Applying SPLT reconstruction technique to TLLH surgery helped achieve favorable short-term therapeutic outcomes. SPLT–TLLH appears feasible and safe with promising short-term outcomes in this single-center retrospective cohort and helps simplify gastrointestinal reconstruction.