Extracorporeal Versus Intracorporeal Anastomosis for Laparoscopic Right Hemicolectomy

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Background: During laparoscopic right hemicolectomy, the anastomosis can be created intra- or extracorporeally. This study aimed to determine whether a difference exists in short-term outcomes between these techniques.

Methods: Prospectively collected data of 80 consecutive patients who underwent laparoscopic right hemicolectomies since 2004 were reviewed retrospectively. An intracorporeal anastomosis was performed in 23 patients, an extracorporeal anastomosis in 57.

Results: There were no significant differences in median length of stay (4 days), number of removed lymph nodes, estimated blood loss, operative time (190 minutes intracorporeal vs. 180 minutes) and postoperative ileus (22% intracorporeal vs. 16%). The incision length was significantly shorter in the intracorporeal group (4cm vs. 5cm; P=0.004). Complications related to the anastomosis including twisting of the mesentery (n=2), anastomotic volvulus (n=1), or leak (n=1) occurred in 4 patients in the extracorporeal group compared with one minor anastomotic leak in the intracorporeal group. Major complication rates were similar between the 2 groups (4.3% intracorporeal vs. 5.3% extracorporeal).

Conclusion: The type of anastomosis does not influence short-term outcomes after laparoscopic right hemicolectomy. An intracorporeal anastomosis results in shorter incision length and may decrease wound-related complications.