Intracorporeal Mechanical Side-to-Side Isoperistaltic Anastomosis in Laparoscopic Right Hemicolectomy: The Best Choice? A Cohort Study

Xavier Serra-Aracil, Laura Mora-López, Anna Pallisera-Lloveras, Sheila Serra-Pla and Salvador Navarro-Soto

Department of General Surgery and Digestive System, Hospital Universitario Parc Taulí de Sabadell, Spain

^*Correspondance to: Xavier Serra-Aracil 

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Abstract:

Purpose: Right hemicolectomy is one of the most frequent procedures in colorectal surgery. Despite the introduction of laparoscopy and fast-track programs, rates of postoperative complications are high; among them, Anastomotic Leak (AL) is the most serious. Objective of the study: to assess whether laparoscopic right hemicolectomy, with intracorporeal mechanical side-to-side isoperistaltic anastomosis, obtains better results in terms of postoperative morbidity and mortality than open surgery or extracorporeal laparoscopy.Methods: Observational cohort study, with prospective data collection and retrospective analysis of three cohorts of 60 consecutive patients undergoing right hemicolectomy and ileocolic anastomosis via open surgery (group 1), laparoscopic surgery with extracorporeal anastomosis (group 2) or laparoscopic surgery with intracorporeal anastomosis (group 3). Overall postoperative morbidity, Comprehensive Complication Index (CCI), AL, reoperation due to AL, Surgical Site Infection (SSI), mortality and hospital stay were analyzed at 30 days.Results: Group 3 obtained significantly better results than groups 1 and 2 in overall morbidity (3:21.7%, 1:48.3%, 2:35%, p=0.009), CCI (3:4, 2 ± 8.8, 1:20.4 ± 29, 2:9 ± 20, p= <0.001), SSI (3:3.3%, 1:36.7%, 2:16.7%; p= <0.001), hospital stay (3:4.5 ± 2, 1:9 ± 9, 2:6 ± 5, p= <0.001), reoperation due to AL (3:0%, 1:15%, 2:3%, p= <0.002) and mortality (3:0%, 1:5%, 2:0%, p= <0.001).Conclusion: Laparoscopic right hemicolectomy with intracorporeal anastomosis obtained the best results. These findings should now be confirmed in prospective randomized multicenter studies.

Keywords:

Right Hemicolectomy; Intracorporeal Anastomosis; Anastomotic Leak; Mechanical Anastomosis; Laparoscopic Right Hemicolectomy

Cite the Article:

Serra-Aracil X, Mora-López L, PalliseraLloveras A, Serra-Pla S, Navarro-Soto S. Intracorporeal Mechanical Sideto-Side Isoperistaltic Anastomosis in Laparoscopic Right Hemicolectomy: The Best Choice? A Cohort Study. Clin Oncol. 2018; 3: 1555.