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Laparoscopic right colectomy: intracorporeal anastomosis versus extracorporeal

Lucas Gerbasi, Rodrigo Pinto, Mariane Camargo, Anna Carolina Dantas, Cintia Kimura, Diego Soares, Fabio Campos, Sergio Nahas, Ivan Cecconelo. HCFMUSP

Introduction: Laparoscopic right colectomy is a standardized procedure. In the beginning of the laparoscopic experience surgeons preferred the extracorporeal anastomosis (ECA). Recently, the preference of intracorporeal anastomosis (ICA) is increasing between coloproctologists due to better esthetic results and lesser hernia risk.

Objective: To compare perioperative morbidity of intracorporeal anastomosis versus extracorporeal anastomosis in laparoscopic right colectomy

Methods: Consecutive 82 patients who underwent surgical laparoscopic right colectomy between 2012 and 2016 were retrospectively reviewed from a prospectively maintained database. The primary outcome was 30-day morbidity, recorded using de Clavien-Dindo classification system. Major complication was defined as Clavien-Dindo classification ≥ 3. Statistical analysis was made using the software SPSS®.

Results: From a total of 82 patients, 24 had ICA and 58 had ECA. Both populations had no difference as related to age, comorbidities, Mass Index (BMI), preoperative hemoglobin or American Society of Anesthesiology (ASA) classification.

Overall, 56 (68,3%) patients had no complications, 21 (25,6%) had minor and 5 (6%) had major complications. The 30-day mortality was 2. Reoperation was necessary for 1 (1,2%) patient, and anastomotic leakage occurred in 1 (1,2%) patient.

The comparison between ICA and ECA did not achieved statistic relevance in any of the categories analyzed. There was a tendency of minor operative time of the ECA group (199 vs 223 minutes, p=0,76).

Conclusion: Laparoscopic right colectomy is a low morbidity surgical procedure. Both ECA and ICA are safe options, leaving the choice of the technique to the surgeon.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 80292

Program Number: P185

Presentation Session: Poster (Non CME)

Presentation Type: Poster

98

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