Outcomes of Intra- versus Extra-Corporeal Ileocolic Anastomosis after Minimally Invasive Right Colectomy for Cancer: An Observational Study

Abstract

Intracorporeal anastomoses (IA) are increasingly being used in colorectal surgery. Some data suggest that these might confer benefits compared with extracorporeal anastomoses (EA). The aim of this study is to compare the short-term complications associated with IA versus EA for minimally invasive right colectomy. This is a single-centre, retrospective study on a prospective database. Patients who underwent minimally invasive right colectomy for cancer between January 2017 and December 2019 were assessed for inclusion. The primary outcome was global 30-day morbidity. Overall, 189 patients were included, of whom 102 had IA. Global morbidity and medical complications were higher in patients with EA (23.5% vs. 40.2%, p = 0.014; 5.9% vs. 14.9%, p = 0.039, respectively). None of the patients with IA had non-infectious surgical wound complications, compared to 4.6% in the EA group (p = 0.029). No differences were found in anastomotic leakage (9.8% vs. 10.3%, p = 0.55). At multivariable analysis, EA was an independent risk factor for both surgical (OR = 3.71 95% CI: 1.06–12.91, p = 0.04) and overall complications (OR = 3.58 95% CI: 1.06–12.12, p = 0.04). IA lowers the risk for global, medical, and surgical complications with minimum risk for wound complications, without increasing the risk of AL.

Extra-corporeal versus Intra-corporeal Anastomosis after Laparoscopic Right Hemi-colectomy: A Propensity Score Matched Study

“…In our study after PSM, the ECA group showed slightly greater overall morbidity than the ICA group (52.4% vs 19% respectively), but it was not statistically significant (p=0.052). Other studies showed similar results (18,19). In our study, we did not find a statistically significant difference in anastomotic leakage between the two groups, which is consistent with other studies (15,20,21).…”

A standardized stepwise approach to minimally invasive ileocolic anastomosis: Tips and tricks for laparoscopic and robotic surgery

“…Lastly, intracorporeal anastomosis, compared with the extracorporeal approach, not only has similar rates of anastomotic leak but has also been shown to lower the risk for global, medical and surgical complications, SSI and wound complications, including the rate of incisional hernias, and to shorten the hospital stay [ 2 , 12 , 13 , 14 ].…”

Stapler size independently predicts postoperative complications following stapled ileocolic anastomosis: A retrospective cohort study

“…There is no consensus on any differences in outcomes based upon these variations [3][4][5][6][7][8][9][10][11]. Therefore, we aimed to assess the impact of the type of stapler used in stapled ileocolic anastomosis on postoperative outcomes.…”

“…There is a variety of staplers that can be used for the construction of stapled ileocolic anastomosis that differ in length and height. There is no consensus on any differences in outcomes based upon these variations [3–11]. Therefore, we aimed to assess the impact of the type of stapler used in stapled ileocolic anastomosis on postoperative outcomes.…”