Extracorporeal Hand-Sewn vs. Intracorporeal Mechanic Anastomosis During Laparoscopic Right Colectomy

Lepiane, Pasquale; Balla, Andrea; Licardie, Eugenio; Saraceno, Federica; Alarcón, Isaías; Scaramuzzo, Rosa; Guida, Anna; Morales‐Conde, Salvador

doi:10.4293/jsls.2022.00039

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…It has been reported that the ICA procedure in MIS for colorectal diseases can provide enhanced recovery after surgery and fewer perioperative complications [ 4 5 6 ]. Although several meta-analyses have already compared ICA and ECA in laparoscopic right hemicolectomy (RHC), most studies included nonrandomized controlled trials (RCTs), and only 1 study included RCTs of laparoscopic RHC.…”

Section: Introductionmentioning

confidence: 99%

Intracorporeal versus extracorporeal anastomosis in minimally invasive right hemicolectomy: systematic review and meta-analysis of randomized controlled trials

Cheong,

Kim,

Lee

et al. 2024

Ann Surg Treat Res

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Purpose Compared with extracorporeal anastomosis (ECA), intracorporeal anastomosis (ICA) is expected to provide some benefits, including a shorter operation time and less intraoperative bleeding. Nevertheless, the benefits of ICA have mainly been evaluated in nonrandomized studies. Owing to the recent update of randomized controlled trials (RCTs) for minimally invasive surgery (MIS) of right hemicolectomy (RHC), the need to measure the actual effect by synthesizing the outcomes of these studies has emerged. Methods We performed a comprehensive search of the PubMed, Embase, and Cochrane databases (from inception to January 30, 2023) for studies that applied ICA and ECA for RHC with MIS. We included 7 RCTs. The operation time, intraoperative blood loss, conversion rate, length of incision, and postoperative outcomes such as ileus, anastomosis leakage, length of hospitalization, and postoperative pain were compared between ICA and ECA. Results A total of 740 patients were included in the study. Among them, 377 and 373 underwent ICA and ECA, respectively. There were significant differences in age (P = 0.003) and incision type (P < 0.001) between ICA and ECA. ICA was associated with a significantly longer operation time (P = 0.033). Although the postoperative pain associated with ICA was significantly lower than that associated with ECA on postoperative day 2 (POD 2) (P = 0.003), it was not different on POD 3 between the groups. Other perioperative outcomes were similar between the 2 groups. Conclusion In this meta-analysis, ICA did not significantly improve short-term outcomes compared to ECA; other advantages to overcome ICA’s longer operation time are not clear.

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Section: Introductionmentioning

confidence: 99%