| 摘要 |
Background: The Enhanced Recovery After Surgery protocol strongly recommends minimally invasive approach to colon cancer for rapid recovery, lower complication rate, and wound-related complications. Intracorporeal anastomosis (ICA) is believed to offer better patient outcome compared with extracorporeal anastomosis (ECA).
MaterialsandMethods: FromJanuary 2021 to January 2022, a prospective observational study comparing ICAwith ECA in patients after elective right hemicolectomy at a local surgical hospital was conducted. We included all patients ≥18 years old who underwent elective right hemicolectomy. Primary outcome was difference in the incidence of surgical site infection and anastomotic leakage postoperatively.
Results: Seventy-one patients had ICA with a mean age of 52 ± 9.8 years, whereas 67 patients had ECA with a mean age 54.- 2 ± 8.7 years.Mean overall operative timewas longer after ICA (169.1 ± 35.7minutes) compared with the ECA group (147 ± 36.9minutes), P = 0.0001. Difference in estimated blood loss (P = 0.60), tumor size (P = 0.57), number of excised lymph nodes (P = 0.19), stage (P = 0.66), and pathology of specimen (P = 0.53) between ICA and ECA was nonsignificant. Patients with ICA after right hemicolectomy had a quicker recovery of bowel function and time to pass stool (ICA: 3.74 ± 0.6 days vs ECA: 4 ± 0.5 days, P = 0.009), early commencement of oral intake (ICA: 2.6 ± 1.1 days vs ECA days: 3.6 ± 1.1, P = 0.0001), and fewer days in hospital (ICA: 4.8 ± 1.1 vs ECA: 6.2 ± 1.4, P = 0.0001) compared with patients with ECA, respectively. There were no significant differences in postoperative complications and causes of readmission between the two groups.
Conclusions: ICA offers comparable postoperative complications to ECA but has enhanced patient outcomes in terms of recovery. |
