Abstract
BackgroundThe purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer.MethodsWe enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed.ResultsA total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications.ConclusionAn FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer.
Highlights
The purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer
There were no significant differences between the ESA and the FEEA groups in terms of age, sex, body mass index, American Society of Anesthesiologists classification, and ‘tumor, node, metastases’ (TNM) classification
Blood loss tended to be somewhat less in the ESA group than in the FEEA group, the difference was not statistically significant (93.1 ± 29.4 ml versus 100.2 ± 40.0 ml; P = 0.05)
Summary
The purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer. Performing anastomosis after colectomy is one of the basic skills of a general surgeon [1]. Bowel anastomosis is conventionally performed using a handsewn technique, which has been practiced successfully for over 100 years [2]. Because stapled anastomosis takes less time to perform and the learning curve for the inexperienced surgeon is short, mechanical stapling devices are widely used in gastrointestinal surgery [3,4,5]. There are several configurations of ileocolonic anastomosis, such as functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) [6]. The end-to-end anastomosis (EEA) is possible only using the handsewn technique.
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