Intracorporeal anastomosis versus extracorporeal anastomosis during laparoscopic right hemicolectomy for colon cancer management | ||||
| Zagazig University Medical Journal | ||||
| Article 7, Volume 26, Issue 6, November 2020, Page 945-954 PDF (851.46 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2020.33794.1885 | ||||
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| Authors | ||||
Ibrahim Heggy1; Taha Biomy2; Mohamed Ali Alabiad   3; Abdelwahab S Almoregy4
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| 1General surgery Department, Faculty of Medicine, Zagazig University | ||||
| 2General surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||||
| 3Pathology Department, Faculty of Medicine, Zagazig University | ||||
| 4General surgery Department, Faculty of Medicine, Zagazig University, zagazig, Egypt | ||||
| Abstract | ||||
| Recently performing laparoscopic right hemicolectomy, which is gaining wide acceptance for management of colon and rectal cancer, could be done throughout either intra-corporeal or extra-intracorporeal approaches of anastomosis. Both approaches have been used and a consensus is lacking.The aim was to compare the short-term and the long-term patients’ outcomes of performing laparoscopic right hemicolectomy that was performed through either extracorporeal or intracorporeal surgical approach in patients with right sided cancer colon. Patients and methods:we analyzed data, retrospectively, from120colon cancer patients who were managed by laparoscopic right hemicolectomy by either intracorporeal or extracorporeal anastomoses. We compared between anastomoses regarding; demographic, clinicopathological, operative, perioperative,postoperative data, and data of disease recurrence, cancer-specific death and survival rates. Results:The duration of the operative time was longer in the group of patients who underwent extracorporeal anastomosis than the group of patients who underwent intracorporeal anastomosis(p =0.003).We found a higher incidence of medical complications in the group of patients who underwent extracorporeal anastomosis than the group of patients who underwent intracorporeal anastomosis(p = 0.049).The group of patients who underwent intracorporeal anastomosis has a shorter hospital stay than the group of patients who underwent extracorporeal anastomosis(p=0.043).We found no significant differences between the two operated groups regarding; disease recurrence, progression,five-year disease free-survival rate and overall-survival rate. Conclusions:We showed that intracorporeal anastomosis has many advantages over the extracorporeal anastomosis as shorted operative time,less pain, faster recovery and a less liability to occurrence of medical complications, but it did not affect long-term patients’ oncologic outcomes as disease progression, recurrence and survival. | ||||
| Keywords | ||||
| colon cancer; laparoscopic right hemicolectomy; intracorporeal; extracorporeal | ||||
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