Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland.
2Nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Kraków, Poland.
Surg Endosc. 2022 Jul;36(7):4977-4982. doi: 10.1007/s00464-021-08854-8. Epub 2021 Nov 3.
The laparoscopic right hemicolectomy is the standard surgical treatment for right-sided colon cancer. The continuity of the digestive tract is restored through ileocolic anastomosis which can be performed extracorporeally or intracorporeally. The study aimed to compare both anastomotic techniques in laparoscopic right hemicolectomy.
A single-blinded two-armed randomized control trial with 1:1 parallel allocation carried out from 2016 to 2020 in a single center. The follow-up period was 30 days. Compared interventions involved extracorporeal and intracorporeal ileocolic anastomosis in laparoscopic right hemicolectomy. The main outcome of the study was bowel recovery measured as the time to the first stool. Other outcomes involved the time to the first flatus, morbidity, and duration of surgery.
One hundred and seventeen patients undergoing a laparoscopic right hemicolectomy with curative intent were eligible for the trial. Eight patients refused to participate. One hundred and two patients were analyzed, 52 in the intracorporeal group and 50 in the extracorporeal group. The groups did not differ in terms of cancer stage or body mass index, but did differ in age and sex. Intracorporeal anastomosis was associated with a shorter time to the first stool than extracorporeal, 32.8 h (26.0-43.7) vs. 41.7 (35.9-50.0), p = 0.017. There was no significant difference in the time to the first flatus, 30 h (23.2-42.3) vs. 26.6 h (21.8-37.3), p = 0.165. Similarly, overall complications did not differ (EC 12/50 vs. IC 10/52, p = 0.56). There were no differences in length of surgery, 190 min (150-230) and 190 min (180-220), p = 0.55.
Intracorporeal ileocolic anastomosis following laparoscopic right hemicolectomy results in slightly faster bowel recovery, with no differences in morbidity and duration of surgery.
腹腔镜右半结肠切除术是治疗右侧结肠癌的标准手术方法。通过回肠结肠吻合术来恢复消化道的连续性，该吻合术可以通过体外或体内进行。本研究旨在比较腹腔镜右半结肠切除术中的两种吻合技术。
这是一项 2016 年至 2020 年在单中心进行的、采用单盲双臂随机对照试验、1:1 平行分配的研究。随访时间为 30 天。比较的干预措施包括腹腔镜右半结肠切除术中的体外和体内回肠结肠吻合术。研究的主要结果是测量首次排便的时间来评估肠道恢复情况。其他结果包括首次排气时间、发病率和手术时间。
117 例接受腹腔镜右半结肠切除术的患者符合试验条件。8 例患者拒绝参与。102 例患者被纳入分析，其中腔内组 52 例，腔外组 50 例。两组在癌症分期或体重指数方面无差异，但在年龄和性别方面存在差异。腔内吻合术与体外吻合术相比，首次排便时间更短，分别为 32.8 小时（26.0-43.7）和 41.7 小时（35.9-50.0），p=0.017。首次排气时间也无显著差异，分别为 30 小时（23.2-42.3）和 26.6 小时（21.8-37.3），p=0.165。同样，总体并发症也没有差异（EC 12/50 与 IC 10/52，p=0.56）。手术时间也没有差异，分别为 190 分钟（150-230）和 190 分钟（180-220），p=0.55。
腹腔镜右半结肠切除术后行体内回肠结肠吻合术可使肠道恢复更快，但发病率和手术时间无差异。
