Mid-term outcomes of intracorporeal versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study from a single institution

Ozawa, Heita; Toyota, Naoyuki; Sakamoto, Junichi; Nakanishi, Hiroki; Nakanishi, Ryota; Fujita, Shin

doi:10.1007/s00595-022-02636-y

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…In some research of IA, the bowel peristalsis recovery after overlap anastomosis (OLA) was found faster than after FEEA, which may be due to isoperistaltic pattern after OLA creating more natural digestive reconstruction over antiperistaltic pattern after FEEA (20,21). However, these studies also showed that the difference between two anastomotic mode was not significant in the incidence of post-complications; On the other hand, the OLA is more complicated than FEEA, which will prolong the anastomotic and operative time (20)(21)(22). Our chief surgeon was adept at FEEA and we opined that the theoretical advantages of OLA may be counterbalanced by our extensive experience of FEEA.…”

Section: Discussionmentioning

confidence: 98%

Intraoperative and postoperative short-term outcomes of intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy

Zhou

et al. 2023

Front. Oncol.

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BackgroundIntracorporeal anastomosis (IA) is a difficult but popular anastomotic approach for reconstruction of digestive tract after laparoscopic right hemicolectomy, which may reduce some limitations faced during extracorporeal anastomosis (EA).MethodsA retrospective review of 78 patients who underwent laparoscopic right hemicolectomy by a veteran surgeon in a high-volume public tertiary hospital, including 50 patients with IA and 28 patients with EA. The intraoperative-related factors and short-term results of the two anastomotic approaches were compared.ResultsThere was no significant difference in demographics and clinical characteristics between the two groups (P>0.05). The intraoperative blood loss was less (P=0.010) and the incision length was shorter (P<0.001) in the intracorporeal group. Postoperative farting time was faster (P=0.005) and postoperative pain score (VAS) was lower (P<0.001) in IA group. Although the anastomotic time of IA was shorter (P<0.001), the operative time of the two groups were similar. And number of lymph nodes harvested, NLR from POD1 to POD3, postoperative hospital stay and overall hospital stay between the two groups were comparable. Except for significant difference in abdominal infection rate, the Clavien-Dindo classification and the incidence of other postoperative complications were not statistically different. Moreover, the morbidity of abdominal infection decreased with time in the IA group (P=0.040).ConclusionIA is a reliable and feasible procedure, which has faster anastomotic time, earlier return of bowel function and superior postoperative comfort of patient, compared to EA. The postoperative complication rate of IA is similar to that of EA, and may be improved with the IA technical maturity of surgeons, which potentially contributes to the development of ERAS.

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Section: Discussionmentioning

confidence: 98%

Intraoperative and postoperative short-term outcomes of intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy

Zhou

et al. 2023

Front. Oncol.

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“…Clinically, it has been found that there are various methods of anastomosis in colorectal resection [22][23][24][25] ,and the reconstruction method of overlapping triangular anastomosis [26] ,in peristalsis is more conducive to the recovery of digestive function [27] .Overlap is one of the most commonly used linear anastomosis methods by surgeons [5,28,29] ,but the choice depends on the surgeon's experience and bias. To better answer this question, we need to analyze the clinical outcomes of overlapping triangulation and other anastomosis procedures in terms of surgical e cacy.…”

Section: Discussmentioning

confidence: 99%

Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

Li,

Shao,

Cai

et al. 2023

Preprint

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Background To systematically evaluate and compare the safety and efficacy of overlapping triangular anastomoses and other anastomoses in total laparoscopic colorectal resection for the treatment of colorectal cancer, and to provide evidence-based medical evidence for clinical practice. Materials and methods PubMed, Embase, Cochrane Library and Web of Science databases were searched until May 2023, published literature related to total laparoscopic overlapping triangular anastomosis colorectal resection versus colorectal resection with other anastomoses was obtained, progressively screened, and eligible studies were included, and finally Meta-analysis was performed by Stata17 software. Results Seven literatures were included. 705 patients were included, including 342 patients who received overlapping triangular anastomoses and 363 patients who received other anastomoses. A meta-analysis of the included metrics showed that overlapping triangular anastomoses and other anastomoses were more effective in terms of operative time (SMD=-0.29, 95%CI-0.82, 0.23, P = 0.278), postoperative exhaust time (SMD=-0.61, 95%CI-0.84,-0.37), P = 0.000), intraoperative blood loss (SMD=-0.06, 95% CI-0.21,0.10, P = 0.493), length of hospital stay (SMD=-0.41, 95% CI-0.86,0.05, P = 0.079), incision length (SMD=-0.70, 95%CI-1.22,-0.19, P = 0.007), anastomosis time (SMD=-0.56, 95%CI-1.09,-0.03, P = 0.040), ground time (SMD=-0.33, 95%CI-0.65,-0.01, P = 0.041), postoperative defecation time (SMD=-0.75, 95%CI-1.39,-0.10, P = 0.023), number of lymph nodes dissection (SMD = 0.21, 95%CI-0.01,0.43, P = 0.063). From the results, it is clear that there was no significant difference between the overlapping triangular anastomosis and other anastomoses in terms of operative time, intraoperative bleeding, length of hospital stay, and number of lymph nodes discharged (P > 0.05). Compared with other anastomoses, the overlapping triangular anastomosis showed a significant difference in terms of shorter postoperative venting time, smaller incision length, shorter anastomosis time, earlier time on the floor, and earlier postoperative defecation time (P < 0.05). Conclusion The overlapping triangular anastomosis in complete laparoscopic colorectal resection is safe and effective, and is superior to other anastomoses in terms of postoperative venting time, incision length, and postoperative defecation time.

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“…Notably, these advantages include reduced postoperative pain, decreased wound infections, earlier recovery of gastrointestinal function, and lower incidence of incisional hernias associated with the Pfannenstiel incision [1][2][3][4][5][6][7] . Additionally, several studies have reported that the mid-to-long-term outcomes of IA are comparable with those of EA [8][9][10] . Generally, IA in colectomy is performed by means of a side-to-side anastomosis (overlap anastomosis [OLA] and functional end-to-end anastomosis [FEEA]) or end-to-end anastomosis (deltashaped anastomosis [DSA]) using linear staplers [11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Optimal intracorporeal anastomosis for colectomy: A comparative experimental evaluation through 3D anastomosis models

Fujii,

Yamamoto,

Kimura

et al. 2024

Preprint

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Intracorporeal anastomosis (IA) is gradually becoming widespread; however, there are no detailed reports on its configuration. The aim of this study was to create three-dimensional IA models and compare their configurations in detail. Three types of IA models were used: overlap anastomosis (OLA), delta-shaped anastomosis (DSA), and functional end-to-end anastomosis (FEEA). In experiment 1, three-dimensional images of each anastomosis model were created. Additionally, the length of each staple line comprising the anastomotic site was measured. In experiment 2, the length of intestinal mobilization required for anastomosis was compared. The circumference of the anastomosis in OLA (141.5 ± 3.3 mm) was significantly greater than those in DSA (87.9 ± 0.9 mm; p < 0.001) and FEEA (89.6 ± 10 mm; p < 0.0001). The length of the intestinal tract after the anastomosis in DSA (33 ± 6.9 mm) was significantly shorter than that in FEEA (76 ± 2 mm; p < 0.0001) and OLA (60 ± 5 mm; p < 0.002). In this study, we successfully constructed three-dimensional images of IA models. OLA may be the least likely cause of stricture, and DSA may contribute to minimizing bowel mobilization required for anastomosis.

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Mid-term outcomes of intracorporeal versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study from a single institution

Cited by 4 publications

References 34 publications

Intraoperative and postoperative short-term outcomes of intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy

Intraoperative and postoperative short-term outcomes of intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right hemicolectomy

Safety and efficacy of overlapping triangular anastomoses in complete laparoscopic colorectal resection: a systematic evaluation and Meta-analysis

Optimal intracorporeal anastomosis for colectomy: A comparative experimental evaluation through 3D anastomosis models

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