Postoperative Complications Associated With Intra- Versus Extracorporeal Anastomosis for Laparoscopic Right Colectomy. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Ishizuka, Mitsuru; Shibuya, Norisuke; Takagi, Kazutoshi; Hachiya, Hiroyuki; Tago, Kazuma; Shimizu, Takayuki; Matsumoto, Takatsugu; Aoki, Taku; Kubota, Keiichi
• Is Part Of: American surgeon. Volume 88:Issue 12(2022)
• Page Start: 2831
• Page End: 2841
• Publication Date: 2022-12
• Subjects: intracorporeal anastomosis -- extracorporeal anastomosis -- postoperative complication; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/00031348211023417
• Languages: English
• ISSNs: 0003-1348

Abstract

Objective: To compare the postoperative complications of intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA) in patients undergoing laparoscopic right colectomy (LRC). Background: Although several studies have compared postoperative complications of ICA and ECA after LRC, most were retrospective studies. Methods: We performed a comprehensive electronic search of the literature to identify studies that compared postoperative complications between ICA and ECA in patients who underwent LRC. We performed meta-analysis using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) of experiencing complications, and we analyzed heterogeneity using I 2 statistics. Results: Fifteen studies consist of randomized controlled trials, case-control studies, and propensity score matching studies involving a total of 3219 patients who underwent LRC were included. Among 1377 patients who received ICA, 255 (18.5%) had postoperative complications, whereas among 1652 patients who received ECA, 373 (22.6%) had such complications. The results of the meta-analysis revealed that ICA was associated with a significantly reduced risk of postoperative complications (RR, .73; 95% CI: .57-.95; P = .02; I 2 = 57%) compared with ECA. Although there was no significant difference between the 2 groups in risk of anastomotic leakage (RR, .67; 95% CI: .39-1.17; P = .16; I 2 = 8%), there was a significant difference between them in risk of surgical site infection (RR, .50; 95% CI: .34-.71; P = .0002; I 2 = 0%). Conclusions: Intracorporeal anastomosis is associated with a reduced risk of postoperative complications compared with ECA in patients undergoing LRC.