Intracorporeal anastomosis could be associated with a higher lymph node yield in right colon cancer surgery: Results of the ICA‐LATAM study, a retrospective, multicentre, comparative analysis in Latin America

Author:

Patrón Uriburu Juan C.1,Araujo Sergio2,Mario Abedrapo3,Billy Jimenez4,Méndez Ramón5,Rossi Gustavo6,Rotholtz Nicolás7ORCID,Luis Romagnolo8,Avellaneda Nicolas9ORCID,Melani Armando10

Affiliation:

1. Colorectal Surgery Department Hospital Británico de Buenos Aires Buenos Aires Argentina

2. Colorectal Surgery Department Hospital Israelita Albert Einstein Sao Paulo Brazil

3. Colorectal Surgery Unit, Department of Surgery Clinical Hospital Univesity of Chile Santiago de Chile Chile

4. Colorectal Surgery Department Hospital General de Mexico ‘Dr. Eduardo Liceaga’ Mexico Mexico

5. Colorectal Surgery Department Hospital Santa Izabel Salvador Brazil

6. Colorectal Surgery Department Hospital Italiano de Buenos Aires Buenos Aires Argentina

7. Colorectal Surgery Department Hospital Aleman de Buenos Aires Buenos Aires Argentina

8. Colorectal Surgery Department Barretos Cancer Hospital Barretos Brazil

9. General Surgery Department CEMIC University Hospital Buenos Aires Argentina

10. Colorectal Surgery Department Staff Americas Medical Service Rio de Janeiro Brazil

Abstract

AbstractAimThe aim of this work was to compare lymph node (LN) yield in patients operated on for right colon cancer (RCC) using a laparoscopic approach between those receiving an intracorporeal (ICA) or extracorporeal anastomosis (ECA).MethodThis is a retrospective multicentre study involving patients operated on for RCC in nine tertiary referral centres in Latin America during a 2‐year period. The main comparative outcome between groups was the number of LNs harvested between groups.ResultsThe study included 416 patients, 261 (62.7%) in the ECA group and 155 (37.3%) in the ICA group. Patients in the ECA group were elderly (66 vs. 61 years, p < 0.001). Patients receiving an ICA achieved a significantly higher LN yield than those receiving an ECA (24 vs. 18, p < 0.001). This group also had a lower percentage of patients achieving a substandard LN yield (<12 LNs) (10% vs. 24.8%, p = 0.001) and more patients achieving a high number of harvested LNs (>32 LNs) (15.5% vs. 8.3%, p = 0.039). In the multivariate analysis, ICA was independently related to the primary outcome (LN yield) (OR 3.28, p = 0.027, 95% CI 1.14–9.38).ConclusionIn this retrospective study, patients operated on for RCC who received an ICA achieved a higher LN yield. Further studies are needed to reconfirm these findings, and also to find an explanation for these results.

Publisher

Wiley

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