Abstract

Laparoscopic right hemicolectomy represents an effective therapeutic approach for right colon cancer (RCC). The primary aim of this study was to evaluate bowel function recovery, length of hospital stay, operative time, and the number of general and anastomosis-related postoperative complications from intracorporeal anastomosis (ICA) vs. extracorporeal anastomosis (ECA); the secondary outcome was the number of lymph nodes retrieved. This observational study was conducted on 108 patients who underwent right hemicolectomy for RCC; after surgical resection, 64 patients underwent ICA and 44 underwent ECA. The operative time was slightly longer in the ICA group than in the ECA group, even though the difference was not significant (199.31 ± 48.90 min vs. 183.64 ± 35.80 min; p = 0.109). The length of hospital stay (7.53 ± 1.91 days vs. 8.77 ± 3.66 days; p = 0.036) and bowel function recovery (2.21 ± 1.01 days vs. 3.45 ± 1.82 days; p < 0.0001) were significantly lower in the ICA group. There were no significant differences in postoperative complications (12% in ICA group vs. 9% in ECA group), wound infection (6% in ICA group vs. 7% in ECA group), or anastomotic leakage (6% in ICA group vs. 9% in ECA group). We did not observe a significant difference between the two groups in the number of lymph nodes collected (19.46 ± 7.06 in ICA group vs. 22.68 ± 8.79 in ECA group; p = 0.086). ICA following laparoscopic right hemicolectomy, compared to ECA, could lead to a significant improvement in bowel function recovery and a reduction in the length of hospital stay in RCC patients.

Highlights

  • The primary aim of this study was to evaluate bowel function recovery, length of hospital stay, operative time, and the number of general and anastomosis-related postoperative complications from intracorporeal anastomosis (ICA) vs. extracorporeal anastomosis (ECA); the secondary outcome was the number of lymph nodes retrieved

  • Statistical significance was assumed for p < 0.05

  • The two groups were demographically comparable; there were no significant differences in age, body mass index (BMI), American Society of Anesthesiologists (ASA) class, previous abdominal surgery, tumor localization, and stage of the disease (Table 1)

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Colon cancer is the third most frequently diagnosed cancer in both sexes, and right colon cancers (RCCs) are often detected at an advanced stage [1]. Laparoscopic right hemicolectomy represents an effective therapeutic approach for RCC. The technique for laparoscopic right hemicolectomy has not been definitively standardized due to concerns regarding the creation of an anastomosis [2]. Recent studies have found some advantages of intracorporeal anastomosis (ICA), compared to extracorporeal anastomosis (ECA), that include fewer postoperative complications, fewer conversions to open surgery, and a shorter length of hospitalization [3,4,5]

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