Intracorporeal ileotransverse anastomosis in laparoscopic right colectomy. Results of randomized clinical trial

Abstract

AIM: to assess the postoperative complications rate in the groups with intra- and extracorporeal ileotransverse anastomosis in laparoscopic right colectomy.PATIENTS AND METHODS: a single-center, randomized, non-inferiority trial was conducted with intention-to-treat data analysis. There were two groups of patients in whom performed laparoscopic right colectomy using a standardized technique. In the main group (n = 39) intracorporeal ileotransverse anastomosis (IA) was formed, in the comparison group — extracorporeal anastomosis (EA) (n = 40).RESULTS: the operation time in the IA group was 192.4 ± 62.3, and in the EA group — 144.1 ± 41.3 minutes (p = 0.0002). The time of anastomosis formation was also significantly different: 53 (35; 71) minutes in intracorporeal and 30 (26; 35) minutes inn extracorporeal methods (p < 0.0001). The morbidity rate was not significantly different (25.6% vs 27.5%; p = 0.95). In the main group it was 25.6%, and in the control group 27.5% (p = 0.95). Postoperative hospital stay in the main group was significantly less — 5 vs 7.3 days in the comparison group (p < 0.001).CONCLUSION: the randomized trial demonstrated that IA is safe and comparable to EA in terms of the morbidity rate, despite its longer operation time. At the same time, in the IA group, patients achieved discharge criteria earlier, which reduced postoperative hospital stay.