Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Jul;24(7):862-867.
doi: 10.1111/codi.16096. Epub 2022 Feb 28.

A multicentre, prospective cohort study of handsewn versus stapled intracorporeal anastomosis for robotic hemicolectomy

Deena Harji  1 , Philippe Rouanet  2 , Eddy Cotte  3 , Anne Dubois  4 , Eric Rullier  1 , Denis Pezet  4 , Guillaume Passot  3 , Christophe Taoum  2 , Quentin Denost  1
Affiliations
Multicenter Study

A multicentre, prospective cohort study of handsewn versus stapled intracorporeal anastomosis for robotic hemicolectomy

Deena Harji et al. Colorectal Dis. 2022 Jul.

Abstract

Aim: Robotic right hemicolectomy is gaining in popularity due to the recognized technical benefits associated with the robotic platform. However, there is a lack of standardization regarding the optimal anastomotic technique in this cohort of patients, namely stapled or handsewn intra- or extra-corporeal anastomosis. The ergonomic benefit associated with the robotic platform lends itself to intracorporeal anastomosis (ICA). The aim of this study was to compare the short-term clinical outcomes of stapled versus handsewn ICA.

Method: A multicentre prospective cohort study was undertaken across four high-volume robotic centres in France between September 2018 and December 2020. All adult patients undergoing an elective robotic right hemicolectomy with an ICA performed and a minimum postoperative follow-up of 30 days were included. The primary endpoint of our study was anastomotic leak within 30 days postoperatively.

Results: A total of 144 patients underwent robotic right hemicolectomy: 92 (63.8%) had a stapled ICA and 52 (36.1%) a handsewn ICA. The operative indication was adenocarcinoma in 90% with a stapled ICA compared with 62% in the handsewn ICA group (p < 0.001). The overall operating time was longer in the handsewn ICA group compared with the stapled ICA group (219 min vs. 193 min; p = 0.001). The anastomotic leak rate was 3.3% in stapled ICA and 3.8% in handsewn ICA (p = 1.00). There was no difference in the rate or severity of postoperative morbidity.

Conclusion: ICA robotic hemicolectomy is technically safe and is associated with low rates of anastomotic leak overall and equivalent clinical outcomes between the two techniques.

Keywords: Right colectomy; handsewn anastomosis; intracorporeal anastomosis; mechanical anastomosis; robotic approach.

PubMed Disclaimer

References

REFERENCES

    1. Emile SH, Elfeki H, Shalaby M, Sakr A, Bassuni M, Christensen P, et al. Intracorporeal versus extracorporeal anastomosis in minimally invasive right colectomy: an updated systematic review and meta-analysis. Tech Coloproctol. 2019;23(11):1023-35.
    1. 2015 European Society of Coloproctology Group. The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit. Colorectal Dis. 2017. https://doi.org/10.1111/codi.13646
    1. Jurowich C, Lichthardt S, Matthes N, Kastner C, Haubitz I, Prock A, et al. Effects of anastomotic technique on early postoperative outcome in open right-sided hemicolectomy. BJS Open. 2019;3(2):203-9.
    1. Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie A, Fitzgerald A. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev. 2011(9):CD004320.
    1. Nordholm-Carstensen A, Schnack Rasmussen M, Krarup PM. Increased leak rates following stapled versus handsewn ileocolic anastomosis in patients with right-sided colon cancer: a nationwide cohort study. Dis Colon Rectum. 2019;62(5):542-8.

Publication types

LinkOut - more resources