Short-term outcomes of intracorporeal versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study from a single institution

• Published in: Surgery today (Tokyo, Japan) Vol. 52; no. 4; pp. 616 - 623
• Main Authors: Ozawa, Heita, Sakamoto, Junichi, Nakanishi, Hiroki, Fujita, Shin
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.04.2022
• Subjects: Anastomosis, Surgical - methods; Cohort Studies; Colectomy - methods; Humans; Laparoscopy - methods; Medicine; Medicine & Public Health; Original Article; Postoperative Complications - epidemiology; Propensity Score; Retrospective Studies; Surgery; Surgical Oncology; Treatment Outcome; Propensity score matching; Laparoscopic colectomy; Intracorporeal anastomosis; Overlap anastomosis; Learning curve
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-021-02375-6

Purpose To compare the postoperative short-term results of intracorporeal anastomosis (IA) using overlap anastomosis (OLA), with those of extracorporeal anastomosis (EA) using functional end-to-end anastomosis (FEEA) or hand-sewn anastomosis (HSA), after laparoscopic colectomy (LAC). Methods The subjects of this retrospective study were 208 patients with colon cancer who underwent OLA, FEEA, or HSA after LAC at our institution, between 2018 and 2021. The short-term results of the OLA group were compared with those of the FEEA and HSA groups, respectively, using a propensity score-matching method. Results The mean operative time for anastomosis was longer in the OLA group than in the FEEA and HSA groups ( p  < 0.0001). The mean blood loss volume was less in the OLA group than in the FEEA and HSA groups ( p  = 0.0344 and p  = 0.0002, respectively). The mean skin incision size was smaller in the OLA group than in the FEEA and HSA groups ( p  < 0.0001 and p  = 0.0031, respectively). None of the patients in the OLA group had surgical site infections. Three to five patients were required for the surgeon to plateau on the learning curve. Conclusion Although IA required more time than EA, the skills appeared to improve with experience and the short-term results were superior to those of EA.