Comparison of different anastomosis methods in laparoscopically assisted left hemicolectomy

Abstract

Abstract Background: This study aims to compare the clinical efficacy of laparoscopically assisted left hemicolectomy with end-to-side anastomosis (ESA) and side-to-side anastomosis (SSA). Methods: A total of 105 patients from the First Affiliated Hospital of Xiamen University and 229 patients from the First Affiliated Hospital of Fujian Medical University were included in this study, conducted from January 2012 to May 2020. The patients were divided into two groups: 146 cases in the ESA group and 188 cases in the SSA group. Clinical data from both groups were compared, and the survival prognosis was followed up. Results: The operation time for the ESA group was significantly shorter than that of the SSA group (197.1±57.7 vs 218.6±67.5, c²=4.298, P=0.039). However, no statistically significant differences were observed in intraoperative blood loss, pain score at 48 hours post-operation, first exhaust time, number of dissected lymph nodes, anastomotic leakage, anastomotic stenosis, anastomotic bleeding, and adhesive intestinal obstruction at 6 months, 12 months, and 24 months (P>0.05). Furthermore, there was no significant difference in the 5-year disease-free survival between the two groups (66.4% vs 63.9%, c²=0.156, P=0.693). Conclusion: Laparoscopically assisted left hemicolectomy with either ESA or SSA for digestive tract reconstruction is feasible. When the tumor is located at the descending colon or the junction of the descending-sigmoid colon, ESA may reduce the need for splenic flexure dissociation during the operation.