Intracorporeal Versus Extracorporeal Ileocolic Anastomosis after Laparoscopic Right Hemicolectomy in Patients with Cancer Colon on the Right Side – A Prospective Comparative Study.

Hassan, Mohamed H.; Mourad, Ahmed; Kamel, Kareem; Abdelshafy, Ahmed A.

doi:10.21608/ejsur.2024.318712.1193

Intracorporeal Versus Extracorporeal Ileocolic Anastomosis after Laparoscopic Right Hemicolectomy in Patients with Cancer Colon on the Right Side – A Prospective Comparative Study.

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

10.21608/ejsur.2024.318712.1193

Abstract

Background: Laparoscopic right hemicolectomy (LRH) is an effective treatment for right colon cancer (RCC). However, the choice between extracorporeal anastomosis (ECA) and intracorporeal anastomosis (ICA) remains controversial.
Aim of the Work: This study aimed to evaluate the effects of ECA and ICA techniques on perioperative safety and postoperative recovery following LRH.
Patients and Methods: A prospective comparison was conducted involving 40 patients diagnosed with right-sided colon cancer between October 2022 and May 2024.
Participants were divided into two groups: Group A (23 patients) underwent LRH with ECA, while Group B (17 patients) underwent total LRH with ICA using a 3-step stapled isoperistaltic technique.
Results: The findings revealed that the mean operative time was significantly longer in the ECA group (246.91 ± 44.97 minutes) than in the ICA group (215.94 ± 36.20 min, P = 0.025). Additionally, the duration of anastomosis was longer in the ECA group (19.48 ± 2.33 minutes) versus ICA (15.35 ± 1.17 min, P < 0.01). Recovery metrics, such as bowel function, time to liquid intake, and hospital stay, were also significantly longer in the ECA group. Postoperative pain, as measured by VAS scores, was notably lower in the ICA group during the first 48 h. However, complications such as bleeding, anastomotic leakage, intestinal obstruction, and SSI were not significantly different between groups, whereas postoperative ileus was significantly more prevalent in the ECA group (34.8% vs. 5.9%; P = 0.03).
Conclusion: The results indicate that LRH with ICA is associated with shorter operative times, quicker recovery of bowel function, earlier resumption of oral intake, reduced hospital stays, and lower postoperative pain in the initial recovery period than LRH with ECA, without compromising oncologic outcomes or safety.

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