Comparative study of intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy for right colon cancer

Abstract

There is no standard operating method for anastomosis in laparoscopic right colectomy. Although there is currently inadequate evidence, some published researches demonstrate the superiority of intracorporeal ileocolic anastomosis (IIA). To compare IIA with extracorporeal ileocolic anastomosis (EIA) in laparoscopic right colectomy. Between January 2021 and October 2024, 120 laparoscopic right colectomy patients participated in this trial. Patients were randomly grouped into two groups, IIA group (n = 60) and EIA group (n = 60). Both groups were compared regarding clinical aspects, intraoperative features, postoperative recovery, oncological outcomes, and short-term complications. There were no statistically significant difference between study arms regarding demographic criteria and preoperative clinical aspects. Patients within IIA group experienced statistically significant less postoperative pain measured by VAS score on day 0 (p = 0.009), day 2 (p = 0.013), and day 4 (p = 0.0007) and more rapid gastrointestinal recovery measured by time to first flatus (p = 0.0004). However, IIA had longer average operative time than EIA. Otherwise, oncological outcome, and short-term complications were comparable between the study arms with no statistically significant differences. IIA is superior to EIA regarding postoperative pain and return of gastrointestinal motility. Longer operative time is explained by the more complex technique of IIA requiring more laparoscopic skills and expertise.