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Surgical Endoscopy

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Open Access 03-11-2021 | Hemicolectomy

Bowel function after laparoscopic right hemicolectomy: a randomized controlled trial comparing intracorporeal anastomosis and extracorporeal anastomosis

Authors: Piotr Małczak, Michał Wysocki, Magdalena Pisarska-Adamczyk, Piotr Major, Michał Pędziwiatr

Published in: Surgical Endoscopy | Issue 7/2022

Abstract

Background

The laparoscopic right hemicolectomy is the standard surgical treatment for right-sided colon cancer. The continuity of the digestive tract is restored through ileocolic anastomosis which can be performed extracorporeally or intracorporeally. The study aimed to compare both anastomotic techniques in laparoscopic right hemicolectomy.

Materials and methods

A single-blinded two-armed randomized control trial with 1:1 parallel allocation carried out from 2016 to 2020 in a single center. The follow-up period was 30 days. Compared interventions involved extracorporeal and intracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy. The main outcome of the study was bowel recovery measured as the time to the first stool. Other outcomes involved the time to the first flatus, morbidity, and duration of surgery.

Results

One hundred and seventeen patients undergoing a laparoscopic right hemicolectomy with curative intent were eligible for the trial. Eight patients refused to participate. One hundred and two patients were analyzed, 52 in the intracorporeal group and 50 in the extracorporeal group. The groups did not differ in terms of cancer stage or body mass index, but did differ in age and sex. Intracorporeal anastomosis was associated with a shorter time to the first stool than extracorporeal, 32.8 h (26.0–43.7) vs. 41.7 (35.9–50.0), p = 0.017. There was no significant difference in the time to the first flatus, 30 h (23.2–42.3) vs. 26.6 h (21.8–37.3), p = 0.165. Similarly, overall complications did not differ (EC 12/50 vs. IC 10/52, p = 0.56). There were no differences in length of surgery, 190 min (150–230) and 190 min (180–220), p = 0.55.

Conclusion

Intracorporeal ileocolic anastomosis following laparoscopic right hemicolectomy results in slightly faster bowel recovery, with no differences in morbidity and duration of surgery.

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Title: Bowel function after laparoscopic right hemicolectomy: a randomized controlled trial comparing intracorporeal anastomosis and extracorporeal anastomosis
Authors: Piotr Małczak
Michał Wysocki
Magdalena Pisarska-Adamczyk
Piotr Major
Michał Pędziwiatr
Publication date: 03-11-2021
Publisher: Springer US
Keywords: Hemicolectomy
Hemicolectomy
Published in: Surgical Endoscopy / Issue 7/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-021-08854-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Bowel function after laparoscopic right hemicolectomy: a randomized controlled trial comparing intracorporeal anastomosis and extracorporeal anastomosis

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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