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Erschienen in:
01.05.2013
Laparoscopic right colon resection with intracorporeal anastomosis
Erschienen in: Surgical Endoscopy | Ausgabe 5/2013
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Background
This study was performed to evaluate short-term clinical outcomes of laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon.
Methods
This was a retrospective study of selected patients who underwent laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon for tumors or Crohn’s disease by a single surgeon from July 2002 through June 2012. Data were retrieved from an Institutional Review Board-approved database. Study end point was postoperative adverse events, including mortality, complications, reoperations, and readmissions at 30 days. Antiperistaltic side-to-side anastomoses were fashioned laparoscopically with a 60-mm-long stapler cartridge and enterocolotomy was hand-sewn intracorporeally in two layers. Values were expressed as medians (ranges) for continuous variables.
Results
There were 243 patients (143 females) aged 61 (range = 19–96) years, with body mass index of 29 (18–43) kg/m2 and ASA 1:2:3:4 of 52:110:77:4; 30 % had previous abdominal surgery and 38 % had a preexisting comorbidity. There were 84 ileocolic resections with ileo ascending anastomosis and 159 right colectomies with ileotransverse anastomosis. Operating time was 135 (60–220) min. Estimated blood loss was 50 (10–600) ml. Specimen extraction site incision length was 4.1 (3–4.4) cm. Conversion rate was 3 % and there was no mortality at 30 days, 15 complications (6.2 %), and 8 reoperations (3.3 %). Readmission rate was 8.7 %. Length of stay was 4 (2–32) days. Pathology confirmed Crohn’s disease in 84 patients, adenocarcinoma in 152, and other tumors in 7 patients.
Conclusion
Laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon resulted in a favorable outcome in selected patients with Crohn’s disease or tumors of the right colon.