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While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes.
One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018.
ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group.
In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain.
Clinical trial (Identifier: NCT03934151).
Rausa E, Kelly ME, Asti E, Aiolfi A, Bonitta G, Bonavina L (2019) Right hemicolectomy: a network meta-analysis comparing open, laparoscopic-assisted, total laparoscopic, and robotic approach. Surg Endosc 33:1020–1032 CrossRef
Ohtani H, Tamamori Y, Artimoto Y, Nishiguchi Y, Maeda K, Hirakawa K (2012) A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and open colectomy for colon cancer. J Cancer 3:49–57 CrossRef
Lezoche E, Feliciotti F, Paganini AM, Guerrieri M, De Sanctis A, Minervini S, Campagnacci R (2002) Laparoscopic vs. open hemicolectomy for colon cancer. Surg Endosc 16:596–602 CrossRef
Jian-Cheng T, Wang SS, Bo Z, Jian F, Liang Z (2016) Total laparoscopic right hemicolectomy with 3-step stapled intracorporeal isoperistaltic ileocolic anastomosis for colon cancer. An evaluation of short term outcomes. Medicine 95:48 CrossRef
Casciola L, Ceccarelli G, Di Zitti L (2003) Laparoscopic right hemicolectomy with intracorporeal anastomosis. Technical aspects and personal experience. Minerva Chir 58:621–627 PubMed
Vergis AS, Steigerwald SN, Bhojani FD, Sullivan PA, Hardy KM (2015) Laparoscopic right hemicolectomy with intracorporeal versus extracorporeal anastamosis: a comparison of short-term outcomes. Can J Surg 58:63–68 CrossRef
Abrisqueta J, Iban N, Luja J, Hernández Q, Parrilla P (2016) Intracorporeal ileocolic anastomosis in patients with laparoscopic right hemicolectomy. Surg Endosc 30:65–72 CrossRef
Krouchev R, Tamana S, Nguyen N, Yorke E, Harris D, Sampath S (2018) Total intracorporeal anastomosis for right hemicolectomy: experience from a Canadian center. Am J Surg 215:905–908 CrossRef
Sun X, Qiu H, Fei K, Xu L, Lu J, Zhang G, Xiao Y (2017) Comparison of intra-abdominal infection between intracorporeal anastomosis and extracorporeal anastomosis in patients undergoing laparoscopic right hemicolectomy. Zhonghua Wei Chang Wai Ke Za Zhi 20(8):891–895 PubMed
Bollo J, Salas P, Martinez MC, Hernandez P, Rabal A, Carrillo E, Targarona E (2018) Intracorporeal versus extracorporeal anastomosis in right hemicolectomy assisted by laparoscopy: study protocol for a randomized controlled trial. Int J Colorectal Dis 33:1635–1645 CrossRef
Milone M, Elmore U, Di Salvo E, Delrio P, Bucci L, Ferulano GP, Napolitano C, Angiolini MR, Bracale U, Clemente M, D’Ambra M, Luglio G, Musella M, Pace U, Rosati R, Milone F (2015) Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers. Surg Endosc 29:2314–2320 CrossRef
Anania G, Santini M, Scagliarini L, Marzetti A, Vedana L, Marino S, Gregorio C, Resta G, Cavallesco G (2012) A totally mini-invasive approach for colorectal laparoscopic surgery. World J Gastroenterol 18:3869–3874 CrossRef
Carnuccio P, Jimeno J, Pares D (2014) Laparoscopic right colectomy: a systematic review and meta-analysis of observational studies comparing two types of anastomosis. Tech Coloproctol 18:5–12 CrossRef
Chang K, Fakhoury M, Barnajian M, Tarta C, Bergamaschi R (2013) Laparoscopic right colon resection with intracorporeal anastomosis. Surg Endosc 27:1730–1736 CrossRef
Feroci F, Lenzi E, Garzi A, Vannucchi A, Cantafio S, Scatizzi M (2013) Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis. Int J Colorectal Dis 28:1177–1186 CrossRef
Lee KH, Ho J, Akmal Y, Nelson R, Pigazzi A (2013) Short- and long-term outcomes of intracorporeal versus extracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy for colon cancer. Surg Endosc 27:1986–1990 CrossRef
Magistro C, Di Lernia S, Ferrari G, Zullino A, Mazzola M, De Martini P, De Carli S, Forgione A, Bertoglio CL, Pugliese R (2013) Totally laparoscopic versus laparoscopic-assisted right colectomy for colon cancer: is there any advantage in short-term outcomes? A prospective comparative assessment in our center. Surg Endosc 27:2613–2618 CrossRef
ClearyI RK, Kassir A, Johnson CS, Bastawrous AL, Soliman MK, Marx DS, Giordano L, Reidy TJ, Parra-Davila E, Obias VJ, Carmichael JC, Pollock D, Pigazzi A (2018) Intracorporeal versus extracorporeal anastomosis for minimally invasive right colectomy: a multi-center propensity scorematched comparison of outcomes. PLoS ONE 13(10):e0206277 CrossRef
Ricci C, Casadei R, Alagna V, Zani E, Taffurelli G, Pacilio CA, Minni F (2017) A critical and comprehensive systematic review and meta-analysis of studies comparing intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy. Langenbecks Arch Surg 402:417–427 CrossRef
Scatizzi M, Kroning KC, Borrelli A, Andan G, Lenzi E, Feroci F (2010) Extracorporeal versus intracorporeal anastomosis after laparoscopic right colectomy for cancer: a case-control study. World J Surg 34:2902–2908 CrossRef
Tarta C, Bishawi M, Bergamaschi R (2013) Intracorporeal ileocolic anastomosis: a review. Tech Coloproctol 17:479–485 CrossRef
van Oostendorp S, Elfrink A, Borstlap W, Schoonmade L, Sietses C, Meijerink J, Tuynman J (2017) Intracorporeal versus extracorporeal anastomosis in right hemicolectomy: a systematic review and meta-analysis. Surg Endosc 31:64–77 CrossRef
Shapiro R, Keler U, Segev L, Sarna S, Hatib K, Hazzan D (2016) Laparoscopic right hemicolectomy with intracorporeal anastomosis: short- and long-term benefits in comparison with extracorporeal anastomosis. Surg Endosc 30:3823–3829 CrossRef
Arezzo A, Passera R, Ferri V, Gonella F, Cirocchi R, Morino M (2015) Laparoscopic right colectomy reduces short-term mortality and morbidity. Results of a systemic review and meta-analysis. Int J Colorectal Dis 30:1457–1472 CrossRef
Cirocchi R, Trastulli S, Farinella E, Guarino S, Desiderio J, Boselli C, Parisi A, Noya G, Slim K (2013) Intracorporeal versus extracorporeal anastomosis during laparoscopic right hemicolectomy—systemic review and meta-analysis. Surg Oncol 22:1–13 CrossRef
Biondi A, Santocchi P, Pennestri F, Santullo F, D’Ugo D, Persiani R (2017) Totally Laparoscopic right colectomy versus laparoscopically assisted right colectomy: a propensity score analysis. Surg Endosc 31:5257–5282 CrossRef
Horan AC, Andrus M, Dudeck MA (2008) CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 36(5):309–332 CrossRef
Clavien PA, Barkum J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibañes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien–Dindo classification of surgical complication: 5-years experience. Ann Surg 250(2):187–196 CrossRef
Martinek L, You K, Giuratrabocchetta S, Gachabayov M, Lee K, Bergamaschi R (2018) Does laparoscopic intracorporeal ileocolic anastomosis decreases surgical site infection rate? A propensity score-matched cohort study. Int J Colorectal Dis 33:291–298 CrossRef
Milone M, Elmore U, Vignali A, Gennarelli N, Manigrasso M, Burati M, Milone F, De Palma GD, Delrio P, Rosati R et al (2018) Recovery after intracorporeal anastomosis in laparoscopic right hemicolectomy: a systematic review and meta-analysis. Langenbeck’s Arch Surg 403:1–1 CrossRef
Hanna MH, Hwang GS, Phelan MJ, Bui TL, Carmichael JC, Mills SD, Stamos MJ, Pigazzi A (2016) Laparoscopic right hemicolectomy: short- and long-term outcomes of intracorporeal versus extracorporeal anastomosis. Surg Endosc 30:3933–3942 CrossRef
Elmore U, Vignali A, Rosati R, Valeri A, Silecchia G, SICE Colorectal Collaborative Group (2019) SICE national Survey: current state on the adoption of laparoscopic approach to the treatment of colorectal disease in Italy. Update Surg 43(2):201–207
Frasson M, Granero-Castro P, Ramos Rodríguez JL, Flor-Lorente B, Braithwaite M, Martí Martínez E, Álvarez Pérez JA, Cazador A, Espí A, Garcia-Granero E, ANACO Study Group et al (2015) Risk factors for anastomotic leak and postoperative morbidity and mortality after elective right colectomy for cancer: results from a prospective, multicentric study of 1102 patients. Int J Colorectal Dis 31:105–114 CrossRef
Aquina CT, Mohile SG, Tejani MA, Becerra AZ, Xu Z, Hensley BJ, Arsalani-Zadeh R, Boscoe FP, Schymura MJ, Noyes K, Monson JR, Fleming FJ (2017) The impact of age on complications, survival, and cause of death following colon cancer surgery. Br J Cancer 116:389–397 CrossRef
The 2015 European Society of Coloproctology Collaborating Group (2017) Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit. Colorectal Dis 19:296–311 CrossRef
Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, Hill AG, Soop M, de Boer HD, Urman RD, Chang GJ, Fichera A, Kessler H, Grass F, Whang EE, Fawcett WJ, Carli F, Lobo DN, Rollins KE, Balfour A, Baldini G, Riedel B, Ljungqvist O (2019) Guidelines for preoperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS) Society Recommendation: 2018. World J Surg 43(3):659–695 CrossRef
- Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis
Wanda Luisa Petz
SICE CoDIG (Colon Dx Italian Group)
- Springer US
And Other Interventional Techniques
Official Journal of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and European Association for Endoscopic Surgery (EAES)
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
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