Unit of General and Minimally Invasive Surgery, Infermi Hospital of Rimini, AUSL Della Romagna, Rimini, Italy -
Unit of General Surgery2, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy -
Minerva Surg. 2022 Dec;77(6):531-535. doi: 10.23736/S2724-5691.22.09281-4. Epub 2022 Mar 1.
Minimally invasive right hemicolectomy is nowadays considered the gold standard for treatment of malignant right colon disease. What is still debated is instead the choice between intracorporeal or extracorporeal anastomosis. The aim of this study was to compare morbidity and the long-term results between these two techniques.
This retrospective, double-center cohort study was performed between January 2013 and December 2014. A total of 197 patients were enrolled after laparoscopic right hemicolectomy for malignant disease. The extracorporeal anastomosis group (ECA) included 95 patients, while the intracorporeal anastomosis group (ICA) included 102 patients. All patients were followed up for 5 years after surgery. Data analysis was performed in February 2021.
The ICA group showed a reduced rate of non-surgical complications Clavien-Dindo grade I-II (10% vs. 31%; P=0.001) as well as a lower rate of wound infections (2% vs. 12%; P=0.01). Most importantly, a decreased risk of incisional hernias in a five-year follow-up period (1% vs. 8%; P=0.01) has been underlined.
Intracorporeal anastomosis technique after totally laparoscopic right hemicolectomy showed better outcomes as it significantly reduces the risk for short and long-term complications, namely, incisional hernias.
微创右半结肠切除术如今被认为是治疗右半结肠癌的金标准。但仍存在争议的是选择体内吻合还是体外吻合。本研究旨在比较这两种技术的发病率和长期结果。
这是一项回顾性、双中心队列研究，于 2013 年 1 月至 2014 年 12 月进行。197 例腹腔镜右半结肠切除术治疗恶性疾病的患者被纳入研究。体外吻合组（ECA）包括 95 例，而体内吻合组（ICA）包括 102 例。所有患者在手术后随访 5 年。数据分析于 2021 年 2 月进行。
ICA 组非手术并发症 Clavien-Dindo 分级 I-II 发生率较低（10% vs. 31%；P=0.001），切口感染发生率也较低（2% vs. 12%；P=0.01）。最重要的是，在 5 年的随访期间，切口疝的风险降低（1% vs. 8%；P=0.01）。
全腹腔镜右半结肠切除术后的体内吻合技术具有更好的效果，因为它显著降低了短期和长期并发症的风险，如切口疝。
