Top

Surgical Endoscopy

Published in:

01-05-2016

Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis

Authors: Kang-Haeng Lee, Sung-Min Lee, Heung-Kwon Oh, Soo-Young Lee, Myong Hoon Ihn, Duck-Woo Kim, Sung-Bum Kang

Published in: Surgical Endoscopy | Issue 5/2016

Abstract

Background

Stapled technique for ileocolic anastomosis is largely supported in previous studies. However, standard anastomotic configuration is not conclusive and studies are limited. This study aims to compare postoperative outcomes between side to side (S–S) and end to side (E–S) stapled anastomosis after laparoscopic right hemicolectomy underenhanced recovery program (ERP).

Methods

Between October 2009 and November 2012, 89 patients (46 in S–S group, 43 in E–S group) who underwent laparoscopic right hemicolectomy for colon cancer and managed with ERP were included in the study. Recovery time and cumulative recovery rates, the length of hospital stays, complication rates were analyzed to compare both configurations.

Results

The recovery time were not different between groups (S–S group, 135 hours [84–183.5] vs E–S group, 117 hours [94–143]; P = 0.349). Difference of cumulative recovery rates were observed in postoperative day 7 (S–S group, 71.7 % vs E–S group, 93.0 %; P = 0.019). The postoperative hospital stay were shorter in E–S group (S–S, 7 days [6-9] vs E–S, 6 days [5–7]; P = 0.003). The overall complication rates were lower in E–S group (26.1 % vs 4.6 %; P = 0.008). Anastomotic leakage was not observed in both groups.

Conclusions

E–S configuration after laparoscopic right hemicolectomy showed favorable outcomes under enhanced recovery program.

Slieker JC, Daams F, Mulder IM, Jeekel J, Lange JF (2013) Systematic review of the technique of colorectal anastomosis. JAMA Surg 148:190–201CrossRefPubMed

Neutzling CB, Lustosa SA, Proenca IM, da Silva EM, Matos D (2012) Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev 15(2):CD003144

Veldkamp R, Gholghesaei M, Bonjer HJ, Meijer DW, Buunen M, Jeekel J, Anderberg B, Cuesta MA, Cuschierl A, Fingerhut A, Fleshman JW, Guillou PJ, Haglind E, Himpens J, Jacobi CA, Jakimowicz JJ, Koeckerling F, Lacy AM, Lezoche E, Monson JR, Morino M, Neugebauer E, Wexner SD, Whelan RL, European Association of Endoscopic Surgery (EAES) (2004) Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery. Surg Endosc 18(8):1163–1185CrossRefPubMed

Goulder Frances (2012) Bowel anastomoses: the theory, the practice and the evidence base. World J Gastrointest Surg 4(9):208–213CrossRefPubMedPubMedCentral

Amri R, Bordeianou LG, Sylla P, Berger DL (2014) Renewed assessment of the stapled anastomosis with the increasing role of laparoscopic colectomy for colon cancer. Surg Endosc. doi:10.1007/s00464-014-3989-5

Kracht M, Hay JM, Fagniez PL, Fingerhut A (1993) Ileocolic anastomosis after right hemicolectomy for carcinoma: stapled or hand-sewn? A prospective, multicenter, randomized trial. Int J Colorectal Dis 8:29–33CrossRefPubMed

Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie A, Fitzgerald A (2011) Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev (9):CD004320. doi:10.1002/14651858.CD004320.pub3

Puleo S, Sofia M, Trovato MA, Pesce A, Portale TR, Russello D, La Greca G (2013) Ileocolonic anastomosis: preferred techniques in 999 patients. A multicentric study. Surg Today 43(10):1145–1149CrossRefPubMed

Liu Zheng, Wang Guiyu, Yang Ming, Chen Yinggang, Miao Dazhuang, Muhammad Shan, Wang Xishan (2014) Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side? World J Surg Oncol 12(1):306CrossRefPubMedPubMedCentral

10.

Lee TG, Kang SB, Kim DW, Hong S, Heo SC, Park KJ (2011) Comparison of early mobilization and diet rehabilitation program with conventional care after laparoscopic colon surgery: a prospective randomized controlled trial. Dis Colon Rectum 54:21–28CrossRefPubMed

11.

Lee SM, Kang SB, Jang JH, Park JS, Hong S, Lee TG, Ahn S (2013) Early rehabilitation versus conventional care after laparoscopic rectal surgery: a prospective, randomized, controlled trial. Surg Endosc 27(10):3902–3909CrossRefPubMed

12.

Boeckxstaens GE, de Jonge WJ (2009) Neuroimmune mechanisms in postoperative ileus. Gut 58(9):1300–1311CrossRefPubMed

13.

Yanagida H, Yanase H, Sanders KM, Ward SM (2004) Intestinal surgical resection disrupts electrical rhythmicity, neural responses, and interstitial cell networks. Gastroenterology 127(6):1748–1759CrossRefPubMed

14.

Kehlet H, Dahl JB (2003) Lancet. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet 362(9399):1921–1928CrossRefPubMed

15.

Smith TK, Robertson WJ (1998) Synchronous movements of the longitudinal and circular muscle during peristalsis in the isolated guinea-pig distal colon. J Physiol 506(Pt 2):563–577PubMedPubMedCentral

16.

Moon SB, Park KJ, Moon JS, Choe EK, So IS, Jung SE (2011) Migrating motor complex changes after side-to-side ileal bypass in mouse ileum ex vivo: mechanism underlying the blind loop syndrome? J Korean Surg Soc 80(4):251–259CrossRefPubMedPubMedCentral

17.

Offodile AC 2nd, Feingold DL, Nasar A, Whelan RL, Arnell TD (2010) High incidence of technical errors involving the EEA circular stapler: a single institution experience. J Am Coll Surg 210(3):331–335CrossRefPubMed

Title: Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis
Authors: Kang-Haeng Lee
Sung-Min Lee
Heung-Kwon Oh
Soo-Young Lee
Myong Hoon Ihn
Duck-Woo Kim
Sung-Bum Kang
Publication date: 01-05-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4420-6

At a glance: The STEP trials

Springer Medicine

Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2016

Long-term outcomes of combined endoscopic/laparoscopic intragastric enucleation of presumed gastric stromal tumors

Evaluation of laparoscopic total gastrectomy for advanced gastric cancer: results of a comparison with laparoscopic distal gastrectomy

Long-term outcomes of percutaneous endoscopic intragastric surgery in the treatment of gastrointestinal stromal tumors at the esophagogastric junction

Doxycycline shows dose-dependent changes in hernia repair strength after mesh repair

Laparoscopic Roux-en-Y gastric bypass patients have an increased lifetime risk of repeat operations when compared to laparoscopic sleeve gastrectomy patients

The First Decade of Laparoscopic Pancreaticoduodenectomy in the United States: Costs and Outcomes Using the Nationwide Inpatient Sample