ORIGINAL ARTICLE   

Chirurgia 2022 December;35(6):329-34

DOI: 10.23736/S0394-9508.21.05362-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Extracorporeal versus intracorporeal stapled anastomosis in laparoscopic right hemicolectomy: preliminary results of Menoufia University Hospital experience

Moharam ABDELSAMIE, Ahmed ELMALLAH ✉, Hatem SOLTAN, Mohammed A. EL BALSHY

Department of General Surgery, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt

BACKGROUND: Laparoscopic right hemicolectomy (LRH) is utilized worldwide as one of the standard surgical treatments for right-sided colon lesions. A lot of concerns regarding its applicability, techniques and trends. Laparoscopic right hemicolectomy with an intracorporeal anastomosis (IA) is less invasive than laparoscopic right hemicolectomy with extracorporeal anastomosis (EA) and is associated with less postoperative morbidity and faster recovery. In spite of this, laparoscopic right hemicolectomy with extracorporeal anastomosis (EA) is the standard technique in many institutes. The aim of this study is to compare the two techniques and to determine the suitability of each method for the patient and the institute.
METHODS: In this retrospective study, data from all cases undergoing elective laparoscopic right hemicolectomy for benign and malignant conditions in Menoufia University Hospitals between January 2012 and December 2017 was collected and analyzed. One hundred and seven patients were included in this study. The two groups were compared for demographic characteristics, preoperative and operative data, operative time, perioperative complications, readmission within 30 days, total hospital stay, and total hospital costs.
RESULTS: The two groups had non-significant differences in the rate of anastomotic leakage, surgical site infection at extraction wound, and readmission within 30 days although a higher number of cases was recorded in Group A (EA); 65 patients vs. 42 patients in group B (IA).
CONCLUSIONS: Laparoscopic right hemicolectomy with intracorporeal anastomosis (IA) or extracorporeal anastomosis (EA) is a safe and feasible procedure. Extracorporeal anastomosis (EA) is associated with less cost and is therefore recommended for institutes with limited funds.

KEY WORDS: Laparoscopy; Colectomy; Anastomosis, surgical; Morbidity