Intracorporeal or extracorporeal anastomosis after minimally invasive right colectomy: a systematic review and meta-analysis

Squillaro, Anthony I.; Köhn, Julia; Weaver, L; Yankovsky, A.; Milky, Gediwon; Patel, Nishant; Kreaden, Usha; Gaertner, Wolfgang B.

doi:10.1007/s10151-023-02850-x

Cited by 6 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is noteworthy that in this study, all IIA procedures utilized a Pfannenstiel incision. Previous research has reported that Pfannenstiel incisions can reduce postoperative pain, minimize incisional infections, and decrease the occurrence of incisional hernias 28 – 30 . However, in our study, no association was observed between EIA and increased incisional infections, possibly due to the use of incision protectors during surgery.…”

Section: Discussionmentioning

confidence: 99%

Short-term outcome of intracorporeal ileocolonic anastomosis in patients with visceral obesity

Guo,

Xia,

Wang

et al. 2024

Sci Rep

View full text Add to dashboard Cite

The primary objective of this study was to compare short-term outcomes between Intracorporeal ileocolic anastomosis (IIA) and extracorporeal ileocolic anastomosis (EIA) after laparoscopic right hemicolectomy in patients with visceral obesity. The secondary objective was to identify risk factors associated with prolonged postoperative ileus (PPOI) after laparoscopic right hemicolectomy. This single-center retrospective study analyzed visceral obesity patients who underwent laparoscopic right hemicolectomy for primary bowel cancer between January 2020 and June 2023. Patients were categorized into IIA and EIA groups based on the type of anastomosis, and a 1:1 propensity score-matched analysis was performed. A total of 129 patients were initially included in this study, with 45 patients in each group following propensity score matching. The IIA group had significantly longer anastomosis times (p < 0.001), shorter incision length (p < 0.001), and shorter length of stay (p = 0.003) than the EIA group. Meanwhile, the IIA group showed a shorter time to first flatus (p = 0.044) and quicker tolerance of a solid diet (p = 0.030). On multivariate analysis, postoperative use of opioid analgesics is an independent risk factor for PPOI (OR: 3.590 95% CI 1.033–12.477, p = 0.044), while IIA is an independent protective factor (OR: 0.195 95% CI 0.045–0.843, p = 0.029). IIA remains a safe and feasible option for visceral obesity patients. It is also associated with a quicker recovery of bowel function and shorter length of stay when compared to EIA. Additionally, IIA is an independent protective factor for PPOI.

show abstract

Section: Discussionmentioning

confidence: 99%

Short-term outcome of intracorporeal ileocolonic anastomosis in patients with visceral obesity

Guo,

Xia,

Wang

et al. 2024

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Previous studies have not reported a reduction in operative time. Some reports indicate that IA and EA are comparable in terms of operative time[ 13 ], but in most reports, IA is longer than EA[ 14 , 15 ], and this applies to robotic surgery[ 16 , 17 ]. On the other hand, the amount of bleeding was significantly lower in IA.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer: A propensity score matching analysis

Kayano,

Mamuro,

Kamei

et al. 2024

World J Gastrointest Surg

View full text Add to dashboard Cite

BACKGROUND Although intracorporeal anastomosis (IA) for colon cancer requires longer operative time than extracorporeal anastomosis (EA), its short-term postoperative results, such as early recovery of bowel movement, have been reported to be equal or better. As IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum, there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor cells. However, intraperitoneal bacterial contamination and medium-term oncological outcomes have not been clarified. AIM To clarify the effects of bacterial and tumor cell contamination of the intra-abdominal cavity in IA. METHODS Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020, 75 underwent EA (EA group), and 52 underwent IA (IA group). After propensity score matching, the primary endpoint was 3-year disease-free survival rates, and secondary endpoints were 3-year overall survival rates, type of recurrence, surgical site infection (SSI) incidence, number of days on antibiotics, and postoperative biological responses. RESULTS Three-year disease-free survival rates did not significantly differ between the IA and EA groups (87.2% and 82.7%, respectively, P = 0.4473). The 3-year overall survival rates also did not significantly differ between the IA and EA groups (94.7% and 94.7%, respectively; P = 0.9891). There was no difference in the type of recurrence between the two groups. In addition, there were no significant differences in SSI incidence or the number of days on antibiotics; however, postoperative biological responses, such as the white blood cell count (10200 vs 8650/mm3, P = 0.0068), C-reactive protein (6.8 vs 4.5 mg/dL, P = 0.0011), and body temperature (37.7 vs 37.5 °C, P = 0.0079), were significantly higher in the IA group. CONCLUSION IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.

show abstract

“…Robotic surgery has enabled enhanced visualization with a three‐dimensional, adjustable motion scale for instruments, articulation of instruments with a high degree of dexterity, and elimination of natural hand tremors, making IA easier than laparoscopic surgery [7–10]. Robotic‐assisted right colectomy (RRC) with IA has been associated with less surgical trauma, improved conversion rates, quicker return of bowel function, lower overall complication rates, and a shorter length of hospitalization than RRC with EA [7–10]. However, RRC with IA requires a significantly longer operation time [9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…Robotic-assisted right colectomy (RRC) with IA has been associated with less surgical trauma, improved conversion rates, quicker return of bowel function, lower overall complication rates, and a shorter length of hospitalization than RRC with EA [7][8][9][10]. However, RRC with IA requires a significantly longer operation time [9,10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A sutureless overlapped anastomosis technique using linear staplers with reinforced bioabsorbable material in robotic right colectomy with intracorporeal anastomosis

Mori,

Kita,

Baba

et al. 2024

Colorectal Disease

View full text Add to dashboard Cite

AimCreation of an overlapped anastomosis using handsewn sutures for common enterotomy is very popular in robotic right colectomy (RRC) with intracorpareal anastomosis (IA). The aim of this study is to present a simple method for constructing a sutureless overlapped anastomosis using a 60 mm linear stapler with a reinforced bioabsorbable material in RRC with IA.MethodThe distal ileum and proximal colon were put in overlapping positions. Enterotomies were created 2 cm proximal to the ileal stump and 8 cm distal to the colonic stump on the antimesenteric side. Subsequently, a 60 mm linear stapler with a reinforced bioabsorbable material was inserted into each lumen and fired. Finally, the bowel was elevated while holding the bioabsorbable material, and the common enterotomy was grasped with the robotic instrument in the middle and closed using a linear stapler with a reinforced bioabsorbable material.ResultsThis technique was applied to 10 patients with tumours of the caecum, ascending colon, or transverse colon. The median operating time, anastomosis construction time, blood loss, and postoperative stay were 281 min (range 228–459 min), 12 min (range 11–17 min), 10 mL (range 0–110 mL), and 10 days (range 8–15 days), respectively. No adverse intraoperative events were observed. Postoperatively, one patient developed chylous ascites, but there were no other complications.ConclusionThe simple technique for constructing a sutureless overlapped anastomosis using a 60 mm linear stapler with a reinforced bioabsorbable material in robotic right colectomy with intracorporeal anastomosis appears to be safe and feasible.

show abstract

Intracorporeal or extracorporeal anastomosis after minimally invasive right colectomy: a systematic review and meta-analysis

Cited by 6 publications

References 46 publications

Short-term outcome of intracorporeal ileocolonic anastomosis in patients with visceral obesity

Short-term outcome of intracorporeal ileocolonic anastomosis in patients with visceral obesity

Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer: A propensity score matching analysis

A sutureless overlapped anastomosis technique using linear staplers with reinforced bioabsorbable material in robotic right colectomy with intracorporeal anastomosis

Contact Info

Product

Resources

About