Mid-term outcomes of intracorporeal versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study from a single institution

Surg Today. 2023 Aug;53(8):992-1000. doi: 10.1007/s00595-022-02636-y. Epub 2023 Jan 19.

Abstract

Purpose: There is still insufficient discussion of the mid- to long-term safety of the intracorporeal anastomosis (IA) method of reconstruction after laparoscopic colectomy (LAC) for colon cancer. The present study clarified the postoperative mid-term results of IA based on recurrence and the incidence of incision hernia.

Methods: This single-institution observational retrospective study included 268 patients with colon cancer who underwent IA or extracorporeal anastomosis (EA) after LAC at our institution between 2018 and 2021. The mid-term results of the IA group were compared with those of the EA group using a propensity score matching method.

Results: The median follow-up periods were 36 and 25 months in the EA and IA groups, respectively (p < 0.0001). In this matched cohort study, the recurrence-free survival (RFS) rates were comparable between the IA and EA groups (each group, n = 72; 3-year RFS: IA, 92.1%; EA, 88.2%; hazard ratio, 0.78; 95% confidence interval, 0.25-2.40; p = 0.66). The cumulative incisional hernia rates were 9.8% and 9.9% (p = 0.99) for the IA and EA groups, respectively.

Conclusion: The safety of IA after LAC was demonstrated in this study, as IA after LAC showed good mid-term results, including with regard to the rates of recurrence and incisional hernia.

Keywords: Intracorporeal anastomosis; Laparoscopic colectomy; Middle-term outcomes; Overlap anastomosis; Propensity score matching.

Publication types

  • Observational Study

MeSH terms

  • Anastomosis, Surgical / methods
  • Cohort Studies
  • Colectomy / methods
  • Colonic Neoplasms* / surgery
  • Humans
  • Incisional Hernia* / surgery
  • Laparoscopy* / methods
  • Propensity Score
  • Retrospective Studies
  • Treatment Outcome