Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis

• Published in: Surgical endoscopy Vol. 30; no. 5; pp. 1952 - 1957
• Main Authors: Lee, Kang-Haeng, Lee, Sung-Min, Oh, Heung-Kwon, Lee, Soo-Young, Ihn, Myong Hoon, Kim, Duck-Woo, Kang, Sung-Bum
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Aged; Anastomosis, Surgical - methods; Anastomotic Leak - epidemiology; Colectomy - methods; Colon, Ascending - surgery; Colonic Neoplasms - surgery; Colorectal cancer; Colorectal surgery; Early Ambulation; Female; Gastroenterology; Gynecology; Hepatology; Hospitals; Humans; Ileus - epidemiology; Laparoscopy; Length of Stay; Male; Medicine; Medicine & Public Health; Middle Aged; Patients; Perioperative Care - methods; Postoperative Complications - epidemiology; Postoperative Hemorrhage - epidemiology; Postoperative Period; Proctology; Recovery (Medical); Retrospective Studies; Review boards; Surgery; Surgical anastomosis; Surgical Wound Infection - epidemiology; South Korea; Laparoscopic surgery; Enhanced recovery program; Ileocolic anastomosis
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-015-4420-6

Background Stapled technique for ileocolic anastomosis is largely supported in previous studies. However, standard anastomotic configuration is not conclusive and studies are limited. This study aims to compare postoperative outcomes between side to side (S–S) and end to side (E–S) stapled anastomosis after laparoscopic right hemicolectomy underenhanced recovery program (ERP). Methods Between October 2009 and November 2012, 89 patients (46 in S–S group, 43 in E–S group) who underwent laparoscopic right hemicolectomy for colon cancer and managed with ERP were included in the study. Recovery time and cumulative recovery rates, the length of hospital stays, complication rates were analyzed to compare both configurations. Results The recovery time were not different between groups (S–S group, 135 hours [84–183.5] vs E–S group, 117 hours [94–143]; P = 0.349). Difference of cumulative recovery rates were observed in postoperative day 7 (S–S group, 71.7 % vs E–S group, 93.0 %; P = 0.019). The postoperative hospital stay were shorter in E–S group (S–S, 7 days [6-9] vs E–S, 6 days [5–7]; P = 0.003). The overall complication rates were lower in E–S group (26.1 % vs 4.6 %; P = 0.008). Anastomotic leakage was not observed in both groups. Conclusions E–S configuration after laparoscopic right hemicolectomy showed favorable outcomes under enhanced recovery program.