Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy A retrospective study and review of literature.

INTRODUCTION: Several studies have suggested that intracorporeal anastomosis (IC) has advantages over extracorporeal anastomosis (EC) in laparoscopic right colectomy. Scientific evidence is lacking. The aim is to define the possible benefits of intracorporeal anastomosis compared with extracorporeal anastomosis in elective surgery. METHODS: A single-centre retrospective study was performed. The primary endpoint was duration of hospital stay. Secondary outcomes included operative time, bowel recovery, conversion to open surgery and postoperative complications. RESULTS: In the IC group mean hospital stay was 7,100 days, mean age was 70,5 years, mean operating time was 233 minutes and mean time to restoration of digestive function was 3,950 days. In the EC group mean hospital stay was 9,455 days, mean age was 72,55 years, mean operating time was 183 minutes, mean time to restoration of digestive function was 5,364 days. CONCLUSION: This study shows many clinical outcomes advantages for the intracorporeal anastomosis technique in laparoscopic right colectomy. IA was associated with earlier bowel recovery, decreased hospital stay and fewer complications; operative time was shorter in EA KEY WORDS: Anastomosis, Colon cancer, Laparoscopy, Hemicolectomy, Retrospective.

Intracorporeal versus Extracorporeal Anastomosis for Laparoscopic Right Hemicolectomy: Short-Term Outcomes.

Laparoscopic right hemicolectomy represents an effective therapeutic approach for right colon cancer (RCC). The primary aim of this study was to evaluate bowel function recovery, length of hospital stay, operative time, and the number of general and anastomosis-related postoperative complications from intracorporeal anastomosis (ICA) vs. extracorporeal anastomosis (ECA); the secondary outcome was the number of lymph nodes retrieved. This observational study was conducted on 108 patients who underwent right hemicolectomy for RCC; after surgical resection, 64 patients underwent ICA and 44 underwent ECA. The operative time was slightly longer in the ICA group than in the ECA group, even though the difference was not significant (199.31 ± 48.90 min vs. 183.64 ± 35.80 min; p = 0.109). The length of hospital stay (7.53 ± 1.91 days vs. 8.77 ± 3.66 days; p = 0.036) and bowel function recovery (2.21 ± 1.01 days vs. 3.45 ± 1.82 days; p < 0.0001) were significantly lower in the ICA group. There were no significant differences in postoperative complications (12% in ICA group vs. 9% in ECA group), wound infection (6% in ICA group vs. 7% in ECA group), or anastomotic leakage (6% in ICA group vs. 9% in ECA group). We did not observe a significant difference between the two groups in the number of lymph nodes collected (19.46 ± 7.06 in ICA group vs. 22.68 ± 8.79 in ECA group; p = 0.086). ICA following laparoscopic right hemicolectomy, compared to ECA, could lead to a significant improvement in bowel function recovery and a reduction in the length of hospital stay in RCC patients.