Intracorporeal stapled ileocolic anastomosis with mechanical closure of the enterotomy after laparoscopic right colectomy for cancer: Keep it Simpler

Akingboye, Akinfemi; Mahmood, Fahad

doi:10.1007/s13304-020-00933-0

Cited by 1 publication

(2 citation statements)

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“…There is no consensus on any differences in outcomes based upon these variations [3][4][5][6][7][8][9][10][11]. Therefore, we aimed to assess the impact of the type of stapler used in stapled ileocolic anastomosis on postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…There is a variety of staplers that can be used for the construction of stapled ileocolic anastomosis that differ in length and height. There is no consensus on any differences in outcomes based upon these variations [3–11]. Therefore, we aimed to assess the impact of the type of stapler used in stapled ileocolic anastomosis on postoperative outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stapler size independently predicts postoperative complications following stapled ileocolic anastomosis: A retrospective cohort study

Garoufalia,

Emile,

Zhou

et al. 2023

Colorectal Disease

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AimStaplers used in ileocolic anastomosis construction differ in length and height. We assessed the impact of stapler type in creating ileocolic anastomoses on postoperative outcomes.MethodsThis retrospective cohort study of an Institutional Review Board approved database included patients who underwent laparoscopic right colectomy for cancer between January 2011 and August 2021. All patients had construction of extracorporeal antiperistaltic stapled ileocolic anastomosis using a linear cutting stapler. Main outcome measures were short‐term (<30 day) morbidity and mortality.ResultsIn all, 270 patients (136 men; median age 70.2 years) were included. A 75 mm stapler was used in 49 (18.1%) patients, 80 mm in 97 (35.9%) and 100 mm in 124 (45.9%). Blue cartridge (stapler height 3.5 mm) was used in 175 (64.5%) and green cartridge (4.8 mm) in 18 (7%) patients; this information was unavailable in 77 (28.5%) cases. Apical enterotomy closure was performed by linear stapler in 54% and linear cutting stapler in 46%. Apical staple line reinforcement or imbrication suturing was used in 26.3%. The overall postoperative complication rate was 28.9%. The anastomotic leak rate was 2.6%. Independent predictors of complications after laparoscopic right colectomy were older age (OR 1.03, 95%CI 1–1.06; P = 0.01), extended colectomy (OR 2.76, 95%CI 1.07–7.08; P = 0.035) and emergency surgery (OR 4.5, 95%CI 1.3–14.9; P = 0.014). A 100‐mm linear cutting stapler was an independent protective factor against postoperative complications (OR 0.3, 95%CI 0.18–0.85; P = 0.019). Stapler height and closure technique of apical enterotomy did not affect postoperative complications.ConclusionIndependent predictors of complications after laparoscopic right colectomy were older age, extended colectomy and emergency surgery. Using a 100 mm stapler was an independent protective factor against postoperative complications.

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