Multicenter prospective study on anastomotic leakage after right-sided colon cancer surgery with laparoscopic intracorporeal overlap anastomosis (KYCC 2101)

Abstract

Aim

Intracorporeal anastomosis (IA) is becoming increasingly popular and replacing extracorporeal anastomosis (EA) for reconstruction in laparoscopic and robotic surgery for right-sided colon cancer (LSRCC). Intracorporeal overlap anastomosis (IOA) is the most widely used IA technique. This study aimed to examine the safety of IOA by investigating its short-term results during the implementation phase.

Methods

This multicenter prospective cohort study was conducted by the Kanagawa Yokohama Colorectal Cancer (KYCC) Study Group. Patients with stage 1–3 colon cancer who planned to undergo LSRCC with IOA reconstruction were eligible. The incidence of anastomotic leakage (AL) of Clavien–Dindo (C–D) grade ≥3 was evaluated as the primary endpoint, and other surgical outcomes and postoperative complications of C–D grades ≥2 were the secondary endpoints.

Results

A total of 127 patients were enrolled, of whom 120 were finally analyzed. The incidence of C–D grade ≥2 complications was 8.3%. The incidence of C–D grade ≥3 AL was 0.8%. This trend was lower than that reported in previous randomized controlled trials (RCTs) and acceptable. Additionally, 1.7% of the patients developed abdominal abscesses, and no cases of anastomotic stenosis were observed. The median operative time was 257 min, and the reconstruction procedure required 32 min. Stapler closure of the enterotomy and facility experience of more than 30 cases were associated with a shorter reconstruction time during IOA.

Conclusion

IOA is feasible and can be safely performed during the implementation phase in patients undergoing LSRCC.