Intracorporeal ileocolic anastomosis: a review

Abstract

This study is a narrative review of the current literature regarding intracorporeal ileocolic anastomosis in laparoscopic right colon resection for benign or malignant diseases of the right colon and terminal ileum. The search strategy included Medline, Embase, CINAHL, ACP Journal Club, and Cochrane databases with laparoscopic right colectomy and intracorporeal anastomosis as keywords. All retrieved references were screened by two independent blinded reviewers. Thirteen papers including 611 patients undergoing laparoscopic right colon resection with intracorporeal ileocolic anastomosis for benign or malignant diseases of the right colon and terminal ileum were identified. There were eight case series and five case control studies. Anastomoses were fashioned as antiperistaltic or isoperistaltic, totally stapled or stapled/handsewn. The mesenteric defect was mostly left open. Overall operating time ranged from 53 to 360 min. The most common specimen extraction site locations were periumbilical, suprapubic, or transvaginal with a median incision length ranging from 3 to 6 cm. The overall rate of surgical site infection was 2.7 %. The anastomotic leak rates varied from 0 to 8.5 %. Postoperative mortality was 0.12 %. Intracorporeal ileocolic anastomosis following laparoscopic resection of the right colon is not commonly performed, but offers potential benefits if carried out by experienced surgeons in selected patients.

Intracorporeal versus Extracorporeal Anastomoses Following Laparoscopic Right Colectomy in Obese Patients: A Case-Matched Study

“…In particular, no significant difference with respect to technical complication, such as the anastomotic leak rate, was observed. Similar results were reported by 4 recent meta-analyses, comparing the 2 surgical techniques in the nonobese population [8][9][10][11][12]. This finding is most likely multifactorial [8][9][10][11][12]14].…”

“…with extensive experience in open and LPS colorectal surgery and familiar with both anastomosis techniques performed all the operations [8,9]. Patients underwent LPS right colectomy with IA or EA depending on surgeon's or patient's preference.…”

Twisting in the wind: intracorporeal ileocolic anastomosis

“…Within the literature, the designation of antiperistaltic versus isoperistaltic anastomoses is infrequently described; however, there is one important consequence that must be considered. The authors prefer antiperistaltic anastomoses, as the focus should be to unalter the rotation of the mesentery with the goal to prevent torsion [8][9][10][11]. Furthermore, a randomized controlled trial concluded that anastomotic leakage occurred only in patients with isoperistaltic anastomoses as compared to antiperistaltic [12].…”

Comparative analysis of single- and multiport laparoscopic right hemicolectomies

“…По некоторым данным, полностью лапароскопические операции позволяют достичь меньшего послеоперационного койко-дня по сравнению с операциями с форми-рованием экстракорпорального анастомоза. Также при этих операциях снижается необходимость ис-пользования наркотических анальгетиков и уско-ряются сроки реабилитации [14,15]. Однако пол-ностью лапароскопические операции не получили широкого распространения, поскольку требуют тщательного отбора пациентов, а для достижения преимуществ они должны выполняться очень опыт-ными лапароскопическими хирургами.…”

“…Однако пол-ностью лапароскопические операции не получили широкого распространения, поскольку требуют тщательного отбора пациентов, а для достижения преимуществ они должны выполняться очень опыт-ными лапароскопическими хирургами. Кроме того, этот вид оперативных вмешательств ограничен сво-ей высокой стоимостью, поскольку формирование анастомоза в подавляющем большинстве случаев производится при помощи сшивающих аппаратов [9,[13][14][15][16]. Таким образом, в основном применя-ются лапароскопически-ассистированные вмеша-тельства.…”