Ileocolonic anastomosis-comparison of different surgical techniques: A single-center study

Medicine (Baltimore). 2022 Dec 23;101(51):e31582. doi: 10.1097/MD.0000000000031582.

Abstract

Right hemicolectomy (RH) is a common procedure for both benign and malignant colic disease. Different anastomotic types are performed during this procedure. To assess the association between anastomotic type and postoperative complications (PC) in patients undergoing RH. Retrospective analysis of medical records of 72 patients (39 female and 33 male), aged 24 to 93, undergoing open RH in the Department of Gastrointestinal Surgery. Data regarding anastomotic type [end-to-end anastomosis, side-to-side (SSA), end-to-side anastomosis, and side-to-end anastomosis (SEA)], and different clinical factors were collected. There were 21 (29%) end-to-end anastomosis, 25 (35%) SSA, 15 (21%) end-to-side anastomosis, and 11 (15%) SEA in the analyzed group. Adenocarcinoma G2 was the most frequent indication for RH - 30 (42%). Total duration of hospitalization (in days) was the longest (14, 26) after SEA and the shortest (12, 68) after SSA. PC were noted in 17(24%) patients. Wound infection was the most common complication noted in 15(21%) patients. The overall anastomotic leak rate was 7% (5/72). PC were the most frequent after SEA noted in 64% (7/11) including abdominal bleeding and bowel perforation. The overall reoperations rate was 6% (4/72). The overall mortality rate was 4% (3/72). SEA was associated with the highest incidence of postoperative complication however based on this and other studies there are no satisfying conclusions regarding the best choice of anastomosis.

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Anastomotic Leak* / epidemiology
  • Anastomotic Leak* / etiology
  • Colectomy* / adverse effects
  • Colectomy* / methods
  • Female
  • Humans
  • Male
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies