Hougaard Emilie Schultz, Schelde-Olesen Benedicte, Al-Najami Issam, Buchbjerg Thomas, Rasmussen Benjamin Schnack Brandt, Bugge Lasse, Kolbro Thomas, Möller Sören, Ellebæk Mark Bremholm
Department of Surgery, Odense University Hospital, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Int J Colorectal Dis. 2025 Apr 8;40(1):90. doi: 10.1007/s00384-025-04882-1.
The purpose of this study is to compare short-term outcomes and 1-year incisional hernia rates between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right hemicolectomy for management of right-sided colonic cancer. The primary outcome was the complication rate assessed by the comprehensive complication index (CCI). Secondary outcomes included time to bowel movement, length of hospital stay, 30-day readmission rate, early warning scores, and 1-year incisional hernia rate.
This was a single-center, prospective cohort study. Patients with right-sided colonic cancer eligible for laparoscopic surgery with primary anastomosis were consecutively included. Patients included in the first period underwent EA, while those in the second underwent IA. Clinical data were collected during the hospital admission up to 30 days postoperatively. Complications were evaluated by the CCI. A routine 1-year CT-scan was used to assess hernias.
One hundred three patients (51 in the EA and 52 in the IA groups) were included. Demographics were similar between the two groups. No significant difference in the CCI-score was found (EA: 17.9 (23.9) vs. IA: 15.0 (17.4), p = 0.85). The mean length of hospital stay was significantly shorter in the IA group (EA 6.6 days, IA 3.9 days, p = 0.02). The groups had no significant differences regarding other outcomes, including hernia rates (p = 0.12).
Laparoscopic right hemicolectomy with IA significantly reduced the length of hospital stay without increasing complication rates compared to EA.
The study is registered at ClinicalTrials.gov (NCT05039762).
本研究旨在比较腹腔镜右半结肠切除术治疗右侧结肠癌时，体内吻合（IA）与体外吻合（EA）的短期结局及1年切口疝发生率。主要结局是通过综合并发症指数（CCI）评估的并发症发生率。次要结局包括排便时间、住院时间、30天再入院率、早期预警评分及1年切口疝发生率。
这是一项单中心前瞻性队列研究。连续纳入符合腹腔镜手术及一期吻合的右侧结肠癌患者。第一阶段纳入的患者接受EA，第二阶段的患者接受IA。收集患者入院至术后30天的临床数据。通过CCI评估并发症。采用常规1年CT扫描评估疝。
共纳入103例患者（EA组51例，IA组52例）。两组患者人口统计学特征相似。CCI评分无显著差异（EA组：17.9（23.9），IA组：15.0（17.4），p = 0.85）。IA组平均住院时间显著缩短（EA组6.6天，IA组3.9天，p = 0.02）。两组在其他结局方面无显著差异，包括疝发生率（p = 0.12）。
与EA相比，腹腔镜右半结肠切除术采用IA可显著缩短住院时间且不增加并发症发生率。
本研究已在ClinicalTrials.gov注册（NCT05039762）。
