Short-term outcomes of intracorporeal delta-shaped overlap versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study

Abstract

Abstract Background Laparoscopic colectomy methods, including intracorporeal anastomosis (IA), are commonly used in clinical practice and have become a research area. Previously, we described a novel IA technique, delta‑shaped overlap anastomosis (DOLA). This study aimed to describe detailed surgical tools for DOLA and their feasibility and safety by comparing short-term DOLA outcomes with those of conventional extracorporeal anastomosis (EA) after propensity score matching. Methods In total, 121 consecutive patients who underwent laparoscopic colectomy between June 2018 and August 2021 were retrospectively assessed. Linear staplers were used for all anastomoses. DOLA and EA groups included 46 and 74 patients, respectively. Propensity score matching analysis was conducted to compare matched groups based on clinicopathological characteristics, surgical and perioperative outcomes, complications, and postoperative inflammatory reactions. After matching, the DOLA and EA groups consisted of 35 cases each that were analyzed. Results Both groups had similar demographic characteristics, surgical procedures, histopathological outcomes, and postoperative complications. The DOLA group had significantly less blood loss than the EA group (10 versus 20 mL, p < 0.001). The DOLA group skin excision length (4 versus 6 cm, p < 0.001) and postoperative hospital stay length (6 versus 7 days, p < 0.001) were significantly shorter than those of the EA group. Increasing C-reactive protein (CRP) values at 1, 3, and 6 postoperative days were significantly lower in the DOLA group than in the EA group (p = 0.02, p = 0.03, and p = 0.04, respectively). Conclusions DOLA was significantly associated with lesser blood loss, shorter skin incision lengths, shorter postoperative hospital stays, and lower CRP level elevations than EA. DOLA is a safe, feasible technique that is potentially less invasive as compared to conventional EA.