Comparison of early results between intracorporeal and extracorporeal anastomosis in laparoscopic colectomy

Abstract

Abstract Introduction: The study aim was to compare the operative time, estimated blood loss, number of harvested lymph nodes, intraoperative and postoperative complications, as well as postoperative recovery between intracorporeal and extracorporeal anastomosis in laparoscopic colectomy for colon cancer. Patients and methods: Retrospective study, case series. From 01/2021 to 8/2022, there were 99 patients, divided into two groups: intracorporeal anastomosis (n = 47) and extracorporeal anastomosis (n = 52). The operative time, estimated blood loss, number of harvested lymph nodes, intraoperative and postoperative complications were compared between two groups. Results: The intracorporeal anastomosis group has significantly shorter time to first flatus (2,7 ± 0,9 vs 3,1 ± 1,0 days; p=0,04) and shorter postoperative hospital stay (6,6 ± 1,7 vs 7,3 ± 1,1 days; p=0,03). Intracorporeal anastomosis can be performed within a comparable time frame as extracorporeal anastomosis, although the anastomosis forming time is significantly longer (33,4 ± 6,0 vs 24,2 ± 6,1 minutes; p<0,001). There was no difference in estimated blood loss, number of harvested lymph nodes, time to first stool, as well as overall complications between two groups. Conclusions: Intracorporeal anastomosis in laparoscopic colectomy is safe, feasible, and does not increase the overall complications and the overall operative time. Intracorporeal anastomosis significantly decreases the time to first flatus, the postoperative hospital length of stay, but prolong the anastomosis forming time as compared to extracorporeal anastomosis. Keywords: intracorporeal anastomosis, extracorporeal anastomosis, laparoscopic colectomy.