Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?

Zheng Liu, Guiyu Wang, Ming Yang, Yinggang Chen, Dazhuang Miao, Shan Muhammad, Xishan Wang, Zheng Liu, Guiyu Wang, Ming Yang, Yinggang Chen, Dazhuang Miao, Shan Muhammad, Xishan Wang

Abstract

Background: The purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer.

Methods: We enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed.

Results: A total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications.

Conclusion: An FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer.

Figures

Figure 1
Figure 1
End-to-side anastomosis: withdrawal of circular stapler.
Figure 2
Figure 2
End-to-side anastomosis: closure of colon by linear stapler.
Figure 3
Figure 3
Functional end-to-end anastomosis: firing of stapler to produce anastomosis.
Figure 4
Figure 4
Functional end-to-end anastomosis: resection of ileocecal site using stapler.

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Source: PubMed

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