38. SHORT-TERM OUTCOMES OF INTRACORPOREAL ANASTOMOSIS IN LAPAROSCOPIC COLECTOMY SURGERY

Dao Minh Nhat1, Tran Thuan Phat1, Lam Quoc Hung1
1 University of Health Sciences, Vietnam National University at Ho Chi Minh City

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Abstract

Purpose: The intracorporeal anastomosis technique in laparoscopic colectomy surgery has advantages such as relatively less invasiveness, faster recovery after surgery, and shorter hospital stays and preserve the oncologic principles. The aim of this study was to evaluate the short-term outcomes of intraoperative anastomosis in laparoscopic colectomy surgery in Thong Nhat hospital.
Method: We retrospectively reviewed all elective laparoscopic hemicolectomies with complete intracorporeal anastomosis performed at Thong Nhat Hospital between January 2021 and August 2023.
Results: There were 22 men (56.41%) and 17 women (43.59%) with an mean age of 71 years (45-89 years). Mean BMI is 20.65 Kg/m2 (16.9 - 23.6 Kg/m2). There were no conversion to open surgery. Average operating time, estimated blood loss, and hospital stay were 262 minutes (120 - 480 minutes), 44 ml (20 - 100 ml), 13 days (7 - 48 days), respectively. The mean incision length is 4.8 cm (3 - 9 cm). The average time to restore intestinal circulation is 2.44 days (2 - 3 days). There were no complications during surgery. Postoperative complications accounted for 7.7%: 1 case of surgical wound infection (2.6%), 2 cases of anastomosis leak (5.1%). The mean number of harvested lymph nodes was 9 lymph nodes (8 - 41 lymph nodes), 79.5% of patients had lymph node metastasis. All cases had R0 resection. The average specimen length is 28 cm (20 -40 cm).
Conclusion: The intraoperative anastomosis in laparoscopic colectomy surgery could be considered a safe and feasible technique for treatment of malignant tumor diseases with low complications rate, short incision length for extraction, faster recovery after surgery.

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References

[1] Emile SH, Elfeki H, Shalaby M, et al (2019). Intracorporeal versus extracorporeal anastomosis in minimally invasive right colectomy: an updated systematic review and meta-analysis. Techniques in coloproctology, 23(11):1023-1035.
[2] Wu Q, Jin C, Hu T, et al (2017). Intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy: a systematic review and meta-analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques, 27(4):348-357.
[3] Mari GM, Crippa J, Costanzi A, et al (2018). Intracorporeal anastomosis reduces surgical stress response in laparoscopic right hemicolectomy: a prospective randomized trial. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 28(2):77-81.
[4] Vignali A, Bissolati M, De Nardi Paola, et al (2016). Extracorporeal vs. intracorporeal ileocolic stapled anastomoses in laparoscopic right colectomy: an interim analysis of a randomized clinical trial. Journal of Laparoendoscopic & Advanced Surgical Techniques, 26(5):343-348.
[5] Allaix ME, Degiuli M, Bonino MA, et al. (2019), Intracorporeal or extracorporeal ileocolic anastomosis after laparoscopic right colectomy: a double-blinded randomized controlled trial. Annals of Surgery, 270(5):762-767.
[6] Bollo J, Turrado V, Rabal A, et al (2020). “Randomized clinical trial of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy (IEA trial)”. Journal of British Surgery, 107(4):364-372
[7] Nguyễn Hoàng Bắc, Đỗ Minh Đại, Từ Đức Hiền (2003), Cắt đại tràng nội soi. Y Học Thành Phố Hồ Chí Minh, 7(1):127-131.
[8] Nguyê̂ n Anh Dũng, Đỗ Đình Công, Phạm Hữu Thông (2003), Kết quã ban đầu cũa phâ̂ u thuật nội soi trong điều trị ung thư đại trực tràng. Y Học Thành Phố Hồ Chí Minh, 7(2):121-124. Đào Văn Cam, Lê Huy Lưu, Hàn Thế Cơ (2019), Kết quả sớm điều trị ung thư đại tràng bằng phẫu thuật nội soi hoàn toàn. Y Học Thành Phố Hồ Chí Minh, 23(1):207-213.