Total intracorporeal anastomosis for right hemicolectomy: Experience from a Canadian center.

BACKGROUND: Laparoscopic right hemicolectomy (LRHC) techniques have varied in the approach to anastomosis. We compared outcomes of laparoscopic right hemicolectomy with extracorporeal anastomosis (ECA) versus intracorporeal anastomosis (ICA).

METHODS: We retrospectively reviewed all LRHCs conducted at Richmond Hospital between January 2015 and October 2017. We compared the demographic, pathologic, intraoperative, and postoperative data.

RESULTS: 74 LRHCs were included during the study period: 56 ECA and 18 ICA. The groups were comparable in age, gender, tumor staging, and tumor location. Incidence of clinical ileus was significantly less for ICA (0% vs. 21%, p = 0.032). Mean length of stay was significantly shorter for ICA (3.13 vs. 4.82 days, p = 0.003). There was no difference between ICA and ECA in mean operative time (158 vs. 145 min, p = 0.087), surgical site infections (6% vs. 4%, p = 1.0), emergency department visits within 30 days (5% vs. 6%, p = 1.0), and hospital readmission within 30 days (4% vs 0%, p = 1.0). There were no incidences of anastomotic leaks, perioperative deaths, or cardiopulmonary complications in either group.

CONCLUSIONS: An ICA approach to LRHC results in shorter hospital stay and decreased rates of clinical ileus.