Colorectal surgery Right laparoscopic hemicolectomy Intracorporeal anastomosis
Chaves JA, Idoate CP, Fons JB, Oliver MB, Rodriguez NP, Delgado AB, et al. A case-control study of extracorporeal versus intracorporeal anastomosis in patients subjected to right laparoscopic hemicolectomy. Cir Esp 2011 Jan;89(1):24-30.
Introduction: There is still insufficient scientific evidence on which is the best technique to
perform the anastomosis -intracorporeal (IC) or extracorporeal (EC)- in right laparoscopic
hemicolectomy. The objective of the present study is to determine whether there are
differences to compare in both techniques.
Material and methods: A study was performed on a prospective patient series subjected to
right laparoscopic hemicolectomy in our Hospital. The preoperative and the postoperative
variables associated with complications recorded depending on the type of anastomosis.
Results: A total of 60 patients were intervened form June 2004 to June 2010 (35 IC; 25 EC).
There were no significant differences between both groups as regards baseline preoperative
characteristics or associated comorbidities. The median operation time was 212 minutes
(142-305 min), with no significant difference between both techniques. The number of
lymph nodes removed was higher in the IC group (21 versus 14; p = 0.03). The beginning
of oral tolerance and the first bowel movement were significantly earlier in the IC group. The
complications rate was similar for both groups (14% IC; 16% EC; p = 0.89). Three patients in
the IC group had anastomosis dehiscence. The mortality rate was 2.8% (one patient in each
Conclusion: Intracorporeal versus extracorporeal anastomosis in right laparoscopic hemicolectomy
can obtain a higher number of resected lymph nodes and an earlier oral tolerance
and intestinal transit.