Comparison study of two anastomosis techniques in right hemicolectomy: a systematic review and pooling up analysis.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-02-25 DOI:10.1007/s00384-025-04835-8

Xiao-Qiang Zhang, Run-Xi Tang, Chao-Fu Zhang, Ming-Yang Xia, Lei-Yuan Shuai, Hua Tang, Guang-Yan Ji

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引用次数: 0

Abstract

Purpose: This study aims to compare side-to-side anastomosis (SSA) and end-to-side anastomosis (ESA) in laparoscopic right hemicolectomy from multiple perspectives to guide the selection of the optimal anastomotic technique.

Methods: This review was pre-registered with PROSPERO (CRD42024614418). A comprehensive literature search was performed using Embase, PubMed, Cochrane Library, and China Biology Medicine (CBM). The primary outcome was anastomotic complications, and secondary outcomes included non-anastomotic complications, short-term prognosis, and surgical parameters.

Results: A total of 18 articles involving 14,555 participants were included in this systematic review and meta-analysis. No significant difference was found between SSA and ESA regarding overall anastomotic complications (OR = 1.14, 95% CI = 0.81 to 1.62, P = 0.45). However, SSA showed advantages in reducing postoperative anastomotic bleeding (OR = 0.64, 95% CI = 0.45 to 0.90, P = 0.01), while ESA appeared more favorable for reducing anastomotic leakage (AL) (OR = 1.29, 95% CI = 0.97 to 1.73, P = 0.08) and intestinal obstruction (OR = 1.20, 95% CI = 0.99 to 1.47, P = 0.07), though these differences were not statistically significant. No significant differences were found in non-anastomotic complications, short-term prognosis, or surgical parameters.

Conclusion: Current clinical evidence suggests that SSA is more effective than ESA in reducing postoperative anastomotic bleeding during right hemicolectomy for cancer. However, no significant differences were observed between the two techniques regarding overall anastomotic.

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两种吻合技术在右半结肠切除术中的比较研究：系统回顾和汇总分析。

目的：从多个角度比较腹腔镜右半结肠切除术中侧侧吻合（SSA）和端侧吻合（ESA），指导最佳吻合技术的选择。方法：本综述在PROSPERO （CRD42024614418）进行预注册。使用Embase、PubMed、Cochrane图书馆和中国生物医学（CBM）进行全面的文献检索。主要结局是吻合口并发症，次要结局包括非吻合口并发症、短期预后和手术参数。结果：本系统综述和荟萃分析共纳入18篇文献，涉及14555名受试者。SSA组与ESA组吻合口总并发症无统计学差异（OR = 1.14, 95% CI = 0.81 ~ 1.62, P = 0.45）。然而，SSA在减少术后吻合口出血方面有优势（OR = 0.64, 95% CI = 0.45 ~ 0.90, P = 0.01），而ESA在减少吻合口漏（OR = 1.29, 95% CI = 0.97 ~ 1.73, P = 0.08）和肠梗阻方面有优势（OR = 1.20, 95% CI = 0.99 ~ 1.47, P = 0.07），但差异无统计学意义。非吻合口并发症、短期预后或手术参数无显著差异。结论：目前的临床证据表明，SSA比ESA更有效地减少肿瘤右半结肠切除术后吻合口出血。然而，两种技术在整体吻合方面没有明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.