Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?

Abstract

BackgroundThe purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer.MethodsWe enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed.ResultsA total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications.ConclusionAn FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer.

Standard and multivisceral colectomy in locally advanced colon cancer

“…The effectiveness of this technique was reported also by Liu et al . 20 Our results do not confirm the association between the postoperative results and blood transfusion suggested by Marinello et al . 14 Despite being a significant predictor in the univariable analysis, blood transfusion was not an independent predictor of complications in the multivariable model.…”

“…We believe that single-layer suture is a simple technique that significantly expedites the procedure, while the endto-end anastomosis avoids the need for additional closure of the intestinal stumps on the proximal and/or distal loops. The effectiveness of this technique was reported also by Liu et al 20 Our results do not confirm the association between the postoperative results and blood transfusion suggested by Marinello et al 14 Despite being a significant predictor in the univariable analysis, blood transfusion was not an independent predictor of complications in the multivariable model.…”

Safety of Anastomoses in Right Hemicolectomy for Colon Cancer

“…Surgical assessment was also performed for the studied patients, focusing on the circumstances and technical aspects of the anastomoses. At the beginning, we analyzed the execution modality, observing that S-E technique is associated with the highest risk of developing anastomotic fistula, being calculated statistically significant odds, while other authors described that E-S variety has the highest risk of association with an anastomotic leakage (13); also, we observed that S-S technique presents the lowest chances of anastomotic leakage and could be considered a protective factor in the development of the fistula (14). Regarding the anastomotic suture layers, we observed similar results concerning single layer and double layer anastomoses, the number of layers showing no influence in the progression through leakage, our results being in accordance to other field researches, which also affirmed no significant differences between suturing in single or double layer (15).…”

Safety of anastomotic techniques and consequences of anastomotic leakage in patients with colorectal cancer: a single surgeon experience

“…However, there are still controversies regarding ileo-colonic anastomosis after right hemicolectomy. According to Liu et al [ 8 ], side to side mechanic anastomotic technique is preferred, while Nordholm-Carstensen et al [ 9 ] sustained that stapled anastomosis had higher rates of AL after right colectomy. Meantime, others stated that handsewn and stapled techniques can be performed with a very low risk of anastomotic leak [ 10 ].…”