Abstract
BackgroundWe compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer.MethodsThis was a retrospective cohort analysis of 92 cases of laparoscopic-assisted resection of right colon cancer, treated from June 2017 to June 2018, at the Huai’an No. 1 People’s Hospital in China. Patients were divided into a modified triangular anastomosis group (n = 33) and a tubular anastomosis group (n = 59). In the modified triangular anastomosis group, digestive tract reconstruction was conducted using side-to-side anastomosis of the ileo-transverse colon with a 60-mm linear stapler. The common entry hole was closed with a running suture. The tubular anastomosis group underwent end-to-side anastomosis of the ileo-transverse colon with a tubular stapler anchor placed at the end of the ileum.ResultsAt baseline and perioperatively, there were no significant between-group differences in age, sex, body mass index, tumor location, pathological stage, or tumour size (P > 0.05). There were also no significant between-group differences in operation time, estimated blood loss, the number of harvested lymph nodes, the first postoperative flatulence time, hospitalisation time, or postoperative complications (P > 0.05); however, the total cost of hospitalization for the triangular anastomosis group was significantly lower than the tubular anastomosis group (P < 0.05).ConclusionModified triangular anastomosis is a safe and feasible procedure for laparoscopic-assisted radical resection of right colon cancer. These results affirm the safety and effectiveness of total laparoscopic radical resection of right colon cancer. Given the equivalent outcomes between the two procedures, the modified triangular procedure may be more a more cost-effective option for clinical application.
Highlights
We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer
Laparoscopic radical resection has become the first choice for treating stage II, and some stage III, right colon cancers [5,6,7]
Triangular anastomosis is commonly used during total laparoscopic surgery, and includes a modified triangular anastomosis and overlapping triangular anastomosis procedures [14]
Summary
We compared the advantages and disadvantages of modified triangular anastomosis and tubular anastomosis for digestive tract reconstruction in patients undergoing laparoscopic-assisted radical resection of right colon cancer. The main anastomotic methods are tubular stapler reconstruction and linear triangular anastomosis [8,9,10,11]. Complete laparoscopic radical resection of right colon cancer has been widely applied. Comparing laparoscopic-assisted and total laparoscopic radical resection of colon cancer, both tubular and triangular anastomoses are feasible approaches. In the modified triangular anastomosis, after excision of the lesion, a small puncture is made on the antimesenteric wall of the ileum and colon respectively. The open end of the colon is closed by the linear stapler [16]
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