Short-term outcomes of intracorporeal versus extracorporeal anastomosis in laparoscopic surgery for right-sided colon cancer: A propensity score-matched study.

Abstract

Recently, intracorporeal anastomosis (IA) has been attracting attention. We aimed to compare the short-term outcomes of IA and extracorporeal anastomosis (EA) in laparoscopic surgery for right-sided colon cancer, after propensity score matching. We retrospectively reviewed 404 consecutive patients with right-sided primary colon cancer between January 2019 and July 2021, 359 of whom underwent laparoscopic surgery. We classified them into IA (n=72) and EA (n=287) groups. Propensity score matching analysis was performed, and the matched groups were compared. The IA group had a longer operation time and shorter time to first flatus, passage of stool, and oral intake. There were no differences in blood loss, postoperative complications, and postoperative hospital stay between the groups. The IA group had a higher inflammatory response in the laboratory data on postoperative day 1 compared to the EA group; however, there were no differences in the incidence of abdominal or surgical site infection (SSI). The IA group had a longer distal resection margin, and there were no peritoneal recurrences in either group. In the IA group, patients had earlier bowel recovery and a longer distal resection margin; however, other postoperative clinical outcomes were comparable. Although there was a higher postoperative inflammatory response in IA, there was no significant difference in postoperative complications, including SSI and intra-abdominal infection. Although long-term outcomes are not yet available, IA could be a useful procedure.