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Minerva Surgery 2022 Mar 01

DOI: 10.23736/S2724-5691.22.09281-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Intracorporeal anastomosis versus extracorporeal anastomosis after laparoscopic right hemicolectomy for colon cancer: morbidity comparison at long-term follow-up

Simone VENERONI 1, 2 , Gian Marco PALINI 1, Basilio PIRRERA 1, Enrico FANTINI 1, Francesco MONARI 1, Vincenzo ALAGNA 1, Carlo VALLICELLI 1, Gianluca GARULLI 1

1 General and Minimally Invasive Surgery, Infermi Hospital of Rimini, AUSL Della Romagna, Rimini, Italy; 2 Unit of General Surgery 2, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy


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BACKGROUND: Minimally invasive right hemicolectomy is nowadays considered the gold standard for treatment of malignant right colon disease. What is still debated is instead the choice between intracorporeal or extracorporeal anastomosis. The aim of this study is to compare morbidity and the long-term results between these two techniques.
METHODS: This retrospective, double-center cohort study was performed between January 2013 and December 2014. A total of 197 patients were enrolled after laparoscopic right hemicolectomy for malignant disease. The Extracorporeal Anastomosis group (ECA) included 95 patients, while the Intracorporeal Anastomosis group (ICA) included 102 patients. All patients were followed up for 5 years after surgery. Data analysis was performed in February 2021.
RESULTS: The ICA group showed a reduced rate of non-surgical complications Clavien-Dindo grade I-II (10% vs 31%; p = 0,001) as well as a lower rate of wound infections (2% vs 12%; p = 0,01). Most importantly, a decreased risk of incisional hernias in a five-year follow-up period (1% vs 8%; p = 0,01) has been underlined.
CONCLUSIONS: Intracorporeal anastomosis technique after totally laparoscopic right hemicolectomy showed better outcomes as it reduces significantly the risk for short and long-term complications, namely, incisional hernias.


KEY WORDS: Right hemicolectomy; Totally laparoscopic colectomy; Intracorporeal anastomosis; Incisional hernia

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