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Observational Study
. 2020 Nov;34(11):4788-4800.
doi: 10.1007/s00464-019-07255-2. Epub 2019 Nov 18.

Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Gabriele Anania  1   2 , Ferdinando Agresta  3 , Elena Artioli  4   5 , Serena Rubino  4   5 , Giuseppe Resta  4   5 , Nereo Vettoretto  6 , Wanda Luisa Petz  7 , Carlo Bergamini  8 , Alberto Arezzo  9 , Giorgia Valpiani  10 , Chiara Morotti  10 , Gianfranco Silecchia  11 ; SICE CoDIG (Colon Dx Italian Group)
Affiliations
Observational Study

Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Gabriele Anania et al. Surg Endosc. 2020 Nov.

Erratum in

Abstract

Background: While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons' attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes.

Methods: One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018.

Results: ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients' characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group.

Conclusions: In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain.

Trial registration: Clinical trial (Identifier: NCT03934151).

Keywords: Ileo-colic anastomosis; Intracorporeal anastomosis; Laparoscopy; Outcomes; Postoperative complications; Right hemicolectomy.

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Figures

Fig. 1
Fig. 1
Mean pain severity divided by group within 48 h post-surgery
See this image and copyright information in PMC

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