Biondi Antonio, Di Mauro Gianluca, Morici Riccardo, Sangiorgio Giuseppe, Vacante Marco, Basile Francesco
Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia 78, 95123 Catania, Italy.
Unit of General Surgery, University Hospital Policlinico-San Marco, 95123 Catania, Italy.
J Clin Med. 2021 Dec 19;10(24):5967. doi: 10.3390/jcm10245967.
Laparoscopic right hemicolectomy represents an effective therapeutic approach for right colon cancer (RCC). The primary aim of this study was to evaluate bowel function recovery, length of hospital stay, operative time, and the number of general and anastomosis-related postoperative complications from intracorporeal anastomosis (ICA) vs. extracorporeal anastomosis (ECA); the secondary outcome was the number of lymph nodes retrieved. This observational study was conducted on 108 patients who underwent right hemicolectomy for RCC; after surgical resection, 64 patients underwent ICA and 44 underwent ECA. The operative time was slightly longer in the ICA group than in the ECA group, even though the difference was not significant (199.31 ± 48.90 min vs. 183.64 ± 35.80 min; = 0.109). The length of hospital stay (7.53 ± 1.91 days vs. 8.77 ± 3.66 days; = 0.036) and bowel function recovery (2.21 ± 1.01 days vs. 3.45 ± 1.82 days; < 0.0001) were significantly lower in the ICA group. There were no significant differences in postoperative complications (12% in ICA group vs. 9% in ECA group), wound infection (6% in ICA group vs. 7% in ECA group), or anastomotic leakage (6% in ICA group vs. 9% in ECA group). We did not observe a significant difference between the two groups in the number of lymph nodes collected (19.46 ± 7.06 in ICA group vs. 22.68 ± 8.79 in ECA group; = 0.086). ICA following laparoscopic right hemicolectomy, compared to ECA, could lead to a significant improvement in bowel function recovery and a reduction in the length of hospital stay in RCC patients.
腹腔镜右半结肠切除术是治疗右结肠癌（RCC）的一种有效方法。本研究的主要目的是评估体内吻合（ICA）与体外吻合（ECA）的肠道功能恢复情况、住院时间、手术时间以及一般和吻合相关术后并发症的数量；次要结果是获取的淋巴结数量。本观察性研究对108例行RCC右半结肠切除术的患者进行；手术切除后，64例患者接受ICA，44例接受ECA。ICA组的手术时间略长于ECA组，尽管差异不显著（199.31±48.90分钟对183.64±35.80分钟；P = 0.109）。ICA组的住院时间（7.53±1.91天对8.77±3.66天；P = 0.036）和肠道功能恢复时间（2.21±1.01天对3.45±1.82天；P<0.0001）显著更短。术后并发症（ICA组12%对ECA组9%）、伤口感染（ICA组6%对ECA组7%）或吻合口漏（ICA组6%对ECA组9%）无显著差异。两组收集的淋巴结数量无显著差异（ICA组19.46±7.06个对ECA组22.68±8.79个；P = 0.086）。与ECA相比，腹腔镜右半结肠切除术后行ICA可显著改善RCC患者的肠道功能恢复情况并缩短住院时间。
