Early outcomes from the Minimally Invasive Right Colectomy Anastomosis study (MIRCAST)
- PMID: 37289913
- PMCID: PMC10416692
- DOI: 10.1093/bjs/znad077
Early outcomes from the Minimally Invasive Right Colectomy Anastomosis study (MIRCAST)
Erratum in
-
Correction to: Early outcomes from the Minimally Invasive Right Colectomy Anastomosis study (MIRCAST).Br J Surg. 2023 Nov 9;110(12):1906. doi: 10.1093/bjs/znad306. Br J Surg. 2023. PMID: 37726098 Free PMC article. No abstract available.
Abstract
Background: The impact of method of anastomosis and minimally invasive surgical technique on surgical and clinical outcomes after right hemicolectomy is uncertain. The aim of the MIRCAST study was to compare intracorporeal and extracorporeal anastomosis (ICA and ECA respectively), each using either a laparoscopic approach or robot-assisted surgery during right hemicolectomies for benign or malignant tumours.
Methods: This was an international, multicentre, prospective, observational, monitored, non-randomized, parallel, four-cohort study (laparoscopic ECA; laparoscopic ICA; robot-assisted ECA; robot-assisted ICA). High-volume surgeons (at least 30 minimally invasive right colectomy procedures/year) from 59 hospitals across 12 European countries treated patients over a 3-year interval The primary composite endpoint was 30-day success, defined by two measures of efficacy-absence of surgical wound infection and of any major complication within the first 30 days after surgery. Secondary outcomes were: overall complications, conversion rate, duration of operation, and number of lymph nodes harvested. Propensity score analysis was used for comparison of ICA with ECA, and robot-assisted surgery with laparoscopy.
Results: Some 1320 patients were included in an intention-to-treat analysis (laparoscopic ECA, 555; laparoscopic ICA, 356; robot-assisted ECA, 88; robot-assisted ICA, 321). No differences in the co-primary endpoint at 30 days after surgery were observed between cohorts (7.2 and 7.6 per cent in ECA and ICA groups respectively; 7.8 and 6.6 per cent in laparoscopic and robot-assisted groups). Lower overall complication rates were observed after ICA, specifically less ileus, and nausea and vomiting after robot-assisted procedures.
Conclusion: No difference in the composite outcome of surgical wound infections and severe postoperative complications was found between intracorporeal versus extracorporeal anastomosis or laparoscopy versus robot-assisted surgery.
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.
Figures
Comment in
-
Comment on: Early outcomes from the Minimally Invasive Right Colectomy Anastomosis Study (MIRCAST).Br J Surg. 2023 Sep 6;110(10):1406. doi: 10.1093/bjs/znad237. Br J Surg. 2023. PMID: 37527420 No abstract available.
References
-
- Arezzo A, Passera R, Ferri V, Gonella F, Cirocchi R, Morino M. Laparoscopic right colectomy reduces short-term mortality and morbidity. Results of a systematic review and meta-analysis. Int J Colorectal Dis 2015;30:1457–1472 - PubMed
-
- Rondelli F, Trastulli S, Avenia N, Schillaci G, Cirocchi R, Gullà N et al. Is laparoscopic right colectomy more effective than open resection? A meta-analysis of randomized and nonrandomized studies. Colorectal Dis 2012;14:447–469 - PubMed
-
- Choi DJ, Kim SH, Lee PJ, Kim J, Woo SU. Single-stage totally robotic dissection for rectal cancer surgery: technique and short-term outcome in 50 consecutive patients. Dis Colon Rectum 2009;52:1824–1183 - PubMed
-
- Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH et al. A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol 2012;19:2485–2493 - PubMed
