• Jesper Nors, Thorbjørn Sommer, and Pål Wara.
• 1 Department of Surgery, Randers Regional Hospital , Randers, Denmark .
• J Laparoendosc Adv Surg Tech A. 2018 Nov 1; 28 (11): 1287-1293.

Background And AimsThe prevailing technique in laparoscopic resection of the right colon has been laparoscopic-assisted procedure with externalization of the bowel for extracorporeal creation of the ileocolic anastomosis. The total laparoscopic technique performing all steps intracorporeally, however, has gained increasing interest. The purpose of this study was to describe our experience with creation of an ileocolic intracorporeal anastomosis (IIA) and to determine anastomotic leakage (AL) rate and short-term outcome of performing IIA.Materials And MethodsIn the period 2011-2017, 2 surgeons in two centers performed 96 laparoscopic resections of malignant and premalignant diseases in the right colon. A linear stapler was used to construct an isoperistaltic side-to-side anastomosis, closing the residual defect with a running suture. Data regarding the surgical procedure and the postoperative course were recorded prospectively. Complications were defined as postoperative until the 30th postoperative day. Readmission was defined as any readmission related to the surgical procedure within 90 days postoperative.ResultsAL rate was observed in 4 patients (4.2%, 95% CI = 1.15-10.33). Postoperative complications occurred in a total of 20 patients (20.83%, 95% CI = 13.22-30.33), none of them fatal. Patients with AL had increased risk of other postoperative complications with OR = 14.25 (95% CI = 1.03-757.36, P = .0236) and complications of Clavien-Dindo Grade ≥IIIb (OR = 10.8, P = .012). Smoking was the only factor predisposing to AL. Patients without AL stayed in hospital a median of 3 days, compared with 32 days for patients with AL.ConclusionIIA was found to be a feasible and safe technique in laparoscopic resections of the right colon with an AL rate of 4.2%.

34 keywords...

hide…