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Comparison of short-term and medium-term outcomes between intracorporeal anastomosis and extracorporeal anastomosis for laparoscopic left hemicolectomy

Authors :
Li-Ming Wang
Bor-Kang Jong
Chun-Kai Liao
Ya-Ting Kou
Yih-Jong Chern
Yu-Jen Hsu
Pao-Shiu Hsieh
Wen-Sy Tsai
Jeng-Fu You
Source :
World Journal of Surgical Oncology, Vol 20, Iss 1, Pp 1-10 (2022)
Publication Year :
2022
Publisher :
BMC, 2022.

Abstract

Abstract Background Few studies have evaluated the feasibility and safety of intracorporeal anastomosis (IA) for left hemicolectomy. Here, we aimed to investigate the potential advantages and disadvantages of laparoscopic left hemicolectomy with IA and compare the short- and medium-term outcomes between IA and extracorporeal anastomosis (EA). Methods We retrospectively analyzed 133 consecutive patients who underwent laparoscopic left hemicolectomies from July 2016 to September 2019 and categorized them into the IA and EA groups. Patients with stage 4 disease and conversion to laparotomy or those lost to follow-up were excluded. Postoperative outcomes between IA and EA groups were compared. Short-term outcomes included postoperative pain score, bowel function recovery, complications, duration of hospital stay, and pathological outcome. Medium outcomes included overall survival and disease-free survival for at least 2 years. Results After excluding ineligible patients, the remaining 117 underwent IA (n = 40) and EA (n = 77). The IA group had a shorter hospital stay, a shorter time to tolerate liquid or soft diets, and higher serum C-reactive protein level on postoperative day 3. There was no difference between two groups in operative time, postoperative pain, specimen length, or nearest margin. A 2-year overall survival (IA vs. EA: 95.0% vs. 93.5%, p = 0.747) and disease-free survival (IA vs. EA: 97.5% vs. 90.9%, p = 0.182) rates were comparable between two groups. Conclusions Laparoscopic left hemicolectomy with IA was technically feasible, with better short-term outcomes, including shorter hospital stays and shorter time to tolerate liquid or soft diets. The IA group had higher postoperative serum C-reactive protein level; however, no complications were observed. Regarding medium-term outcomes, the overall survival and disease-free survival rates were comparable between IA and EA procedures.

Details

Language :
English
ISSN :
14777819
Volume :
20
Issue :
1
Database :
Directory of Open Access Journals
Journal :
World Journal of Surgical Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.7cedd22ee134618bad6a6125d42b2e0
Document Type :
article
Full Text :
https://doi.org/10.1186/s12957-022-02735-7