Short-term outcomes of delta-shaped anastomosis versus functional end-to-end anastomosis using linear staplers for colon cancer

Abstract

Background Several methods are used for reconstruction in colon cancer surgery, including hand-sewn or stapled anastomosis. However, few reports have compared short-term outcomes among reconstruction methods. This study compared short-term outcomes between delta-shaped anastomosis (Delta) and functional end-to-end anastomosis (FEEA). Methods We retrospectively reviewed 1314 consecutive patients who underwent colorectal surgery with FEEA or Delta reconstruction between January 2016 and December 2023. Patients were divided into two groups according to reconstruction by FEEA (F group; n = 1242) or Delta (D group; n = 72). Propensity score matching was applied to minimize the possibility of selection bias and to balance covariates that could affect postoperative complications. Short-term outcomes were compared between groups. Results Postoperative complications occurred in 215 patients (17.3%) in F group and 8 patients (11.1%) in D group. Before matching, transverse colon cancer was more frequent (p = 0.002), clinical N-positive status was less frequent (44.1% vs 16.7%, p < 0.001), distant metastasis was less frequent (11.7% vs 1.4%, p = 0.003), and laparoscopic approach was more frequent (87.8% vs 100%, p < 0.001) in D group. After matching, no differences in any clinical factor were evident between groups. Blood loss was lower (28 mL vs 10 mL, p = 0.002) in D group. However, operation time and postoperative complication rates were similar between groups. Conclusions Delta and FEEA were both considered safe as reconstruction methods. Delta anastomosis may be more useful for patients with transverse colon cancer for whom transfusion should be minimized.