Intracorporeal ileocolic anastomosis in patients with laparoscopic right hemicolectomy

Abrisqueta, Jesús; Ibáñez, Noelia; Luján, Juan; Hernández, Quiteria; Parrilla, Pascual

doi:10.1007/s00464-015-4162-5

Cited by 17 publications

(10 citation statements)

References 32 publications

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“…11 Nevertheless, the dehiscence rate in our study is in line with the 5.2% leak rate recently reported in the largest monocenter study, including 173 ileocolic intracorporeal anastomoses. 23 In the present series, a similar length of stay was observed in the two groups, despite the lower incidence of postoperative ileus and the earlier recovery of bowel function observed in the IA group. This finding could probably be explained on the basis of the two cases of anastomotic leak that occurred in the IA group, which required reoperation in both cases.…”

Section: Discussionsupporting

confidence: 70%

“…This is in line with the results reported by recent meta-analyses and retrospective and case-matched studies comparing the two surgical techniques. 4,13,15,16,23 One claimed advantage of the intracorporeal technique is avoiding anastomotic twisting and ease of closing the mesenterial defect, despite controversial opinions that exist about the need of closing the mesentery. 15,19 Recently, it has been shown that closure is associated with an increase in complications such as obstruction and anastomotic dehiscence.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Extracorporealvs.Intracorporeal Ileocolic Stapled Anastomoses in Laparoscopic Right Colectomy: An Interim Analysis of a Randomized Clinical Trial

Vignali

Bissolati

Nardi

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Extracorporealvs.Intracorporeal Ileocolic Stapled Anastomoses in Laparoscopic Right Colectomy: An Interim Analysis of a Randomized Clinical Trial

Vignali

Bissolati

Nardi

et al. 2016

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Another advantage of IA is clearer visualization of the mesentery during the procedure. This better view helps to avoid mesenteric twisting, an event reported to be common with EA.…”

Section: Discussionmentioning

confidence: 96%

Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial)

Bollo

Turrado

Fueyo

et al. 2019

British Journal of Surgery

120

132

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Background Several non‐randomized and retrospective studies have suggested that intracorporeal anastomosis (IA) has advantages over extracorporeal anastomosis (EA) in laparoscopic right colectomy, but scientific evidence is lacking. The aim was to compare short‐term outcomes and to define the possible benefits of IA compared with EA in elective laparoscopic right colectomy. Methods An RCT was conducted from May 2015 to June 2018. The primary endpoint was duration of hospital stay. Secondary endpoints were intraoperative technical events and postoperative clinical outcomes. Results A total of 140 patients were randomized. Duration of surgery was longer for procedures with an IA than in those with an EA (median 149 (range 95–215) versus 123 (60–240) min; P < 0·001). Wound length was shorter in the IA group (median 6·7 (4–9·5) versus 8·7 (5–13) cm; P < 0·001). Digestive function recovered earlier in patients with an IA (median 2·3 versus 3·3 days; P = 0·003) and the incidence of paralytic ileus was lower (13 versus 30 per cent; P = 0·022). Less postoperative analgesia was needed in the IA group (mean(s.d.) weighted analgesia requirement 39(24) versus 53(26); P = 0·001) and the pain score was also lower (P = 0·035). The postoperative decrease in haemoglobin level was smaller (mean(s.d.) 8·8(1·7) versus 17·1(1·7) mg/dl; P = 0·001) and there was less lower gastrointestinal bleeding (3 versus 14 per cent; P = 0·031) in the IA group. IA was associated with a significantly better rate of grade I and II complications (P = 0·016 and P = 0·037 respectively). The duration of hospital stay was slightly shorter in the IA group (median 5·7 (range 2–19) versus 6·6 (2–23) days; P = 0·194). Conclusion Duration of hospital stay was similar, but IA was associated with less pain and fewer complications. Registration number: NCT02667860 ( http://www.clinicaltrials.gov).

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“…which could be particularly difficult in the presence of thick and short mesentery [3][4][5]. The aforementioned advantages are potentially in favor of the application of IA in obese patients as reported by several authors [5,7,11]. However, data in the literature specifically addressing this issue in the obese patients are scanty.…”

Section: Discussionmentioning

confidence: 77%

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

Vignali¹,

Elmore²,

Lemma³

et al. 2017

Dig Surg

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Background/Aims: To compare short- and long-term outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in obese (body mass index >30 kg/m²) patients. Patients and Methods: Sixty-four consecutive obese patients who underwent laparoscopic (LPS) right colectomy with IA were matched with 64 patients who underwent LPS right colectomy with EA. Intraoperative variables, short-term outcomes, readmission rates, and morbidity and mortality rates were analyzed along with long-term outcomes. Results: Conversion to open surgery occurred in 4 patients in the IA group and 11 patients in the EA group (p = 0.097). The overall 30-day morbidity rate was 29.6% in the IA and 32.8% in the EA (p = 0.70). No 30-day mortality occurred. Anastomotic leak occurred in 4.7% of patients in the IA group vs. 7.8% in the EA group (p = 0.71). In the IA group, an earlier recovery of bowel function was observed (p = 0.01). No differences were observed with respect to the length of stay and reoperation rate. No 30-day readmission occurred in the IA compared to 5 patients readmitted in the EA group (p = 0.058). A higher incidence of incisional hernia was observed in the EA group (p = 0.033). Conclusion: IA in obese patients is associated with similar short-term outcomes, lower incidence of incisional hernias, and might possibly reduce the risk of hospital readmission.

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Intracorporeal ileocolic anastomosis in patients with laparoscopic right hemicolectomy

Abstract: The intracorporeal procedure is a safe and feasible alternative for creating an ileocolic anastomosis. It involves a similar rate of complications and may prevent some of the drawbacks presented by extracorporeal anastomosis.

Cited by 17 publications

References 32 publications

Extracorporealvs.Intracorporeal Ileocolic Stapled Anastomoses in Laparoscopic Right Colectomy: An Interim Analysis of a Randomized Clinical Trial

Extracorporealvs.Intracorporeal Ileocolic Stapled Anastomoses in Laparoscopic Right Colectomy: An Interim Analysis of a Randomized Clinical Trial

Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial)

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

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