Document Type : Original Article
Authors
1
General surgery Department, Faculty of Medicine, Zagazig University
2
General surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
3
Pathology Department, Faculty of Medicine, Zagazig University
4
General surgery Department, Faculty of Medicine, Zagazig University, zagazig, Egypt
Abstract
Recently performing laparoscopic right hemicolectomy, which is gaining wide acceptance for management of colon and rectal cancer, could be done throughout either intra-corporeal or extra-intracorporeal approaches of anastomosis. Both approaches have been used and a consensus is lacking.The aim was to compare the short-term and the long-term patients’ outcomes of performing laparoscopic right hemicolectomy that was performed through either extracorporeal or intracorporeal surgical approach in patients with right sided cancer colon.
Patients and methods:we analyzed data, retrospectively, from120colon cancer patients who were managed by laparoscopic right hemicolectomy by either intracorporeal or extracorporeal anastomoses. We compared between anastomoses regarding; demographic, clinicopathological, operative, perioperative,postoperative data, and data of disease recurrence, cancer-specific death and survival rates.
Results:The duration of the operative time was longer in the group of patients who underwent extracorporeal anastomosis than the group of patients who underwent intracorporeal anastomosis(p =0.003).We found a higher incidence of medical complications in the group of patients who underwent extracorporeal anastomosis than the group of patients who underwent intracorporeal anastomosis(p = 0.049).The group of patients who underwent intracorporeal anastomosis has a shorter hospital stay than the group of patients who underwent extracorporeal anastomosis(p=0.043).We found no significant differences between the two operated groups regarding; disease recurrence, progression,five-year disease free-survival rate and overall-survival rate.
Conclusions:We showed that intracorporeal anastomosis has many advantages over the extracorporeal anastomosis as shorted operative time,less pain, faster recovery and a less liability to occurrence of medical complications, but it did not affect long-term patients’ oncologic outcomes as disease progression, recurrence and survival.
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