RT Journal Article
SR Electronic
T1 Laparoscopic right hemicolectomy with intracorporeal versus extracorporeal anastamosis: a comparison of short-term outcomes
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 63
OP 68
DO 10.1503/cjs.001914
VO 58
IS 1
A1 Ashley S. Vergis
A1 Sarah N. Steigerwald
A1 Faizal D. Bhojani
A1 Paul A. Sullivan
A1 Krista M. Hardy
YR 2015
UL http://canjsurg.ca/content/58/1/63.abstract
AB Background: There is wide variation among laparoscopic colon resection techniques, including the approach for mobilization and the extent of intracorporal vessel ligation, bowel division or anastamosis. We compared the short-term outcomes of laparoscopic right hemicolectomy (LRHC) with intracorporeal (IA) versus extracorporeal (EA) anastamosis.Methods: We retrospectively reviewed all elective laparoscopic right hemicolectomies performed at St. Joseph’s Hospital between January 2008 and September 2009 and compared the demographic, pathologic, operative and outcome data.Results: Fifty LRHCs were completed during the study period: 21 IA and 29 EA. The groups were similar in age, sex, body mass index, American Society of Anesthesiologists score, previous laparotomy and preoperative invasive pathology. There was no difference between IA and EA in mean duration of surgery (170 v. 181 min, p = 0.78), estimated blood loss (14 v. 42 mL, p = 0.15), perioperative blood transfusions (5% v. 14%, p = 0.29), in-hospital morbidity (33% v. 41%, p = 0.56), out-of-hospital morbidity (19% v. 31% p = 0.34), emergency department visits (10% v. 17%, p = 0.16) or 30-day readmissions (5% v. 7%, p = 0.75). There was 1 anastamotic leak in each group and no perioperative deaths. Median length of stay was significantly shorter for IA (4 v. 5 d, p = 0.05). There were 6 extraction site hernias with EA and none with IA (p = 0.026).Conclusion: Laparoscopic right hemicolectomy with IA has the advantage of a less hernia-prone Pfannenstiel extraction site, faster recovery and shorter stay in hospital EA.