End-to-end Anastomosis With ECHELON ENDOPATH™ Staple Line Reinforcement for Right-sided Colon Cancer: Safety and Feasibility.

Background/aim: Functional end-to-end anastomosis (FEEA) is widely utilized in right-sided colorectal cancer surgery for joining the colon and ileum using mechanical staplers. ECHELON ENDOPATH™ Staple Line Reinforcement (SLR), a synthetic absorbable material introduced in 2020, represents a novel approach to reinforcing the anastomosis. However, surgical outcomes of FEEA utilizing SLR remain unreported in the literature. This retrospective study aimed to evaluate the efficacy and safety of FEEA with SLR compared to conventional FEEA in elective right-sided colon cancer surgery.

Patients and methods: We conducted a retrospective analysis of 159 consecutive patients who underwent elective surgery for right-sided colon cancer at our institution between February 2019 and December 2022. Short-term surgical outcomes were compared between cohorts receiving FEEA with and without SLR.

Results: Analysis revealed no significant differences between groups in operative time, blood loss, postoperative hospital stay duration, or overall complication rates. The SLR group demonstrated a significantly higher proportion of robotic surgical procedures (p<0.001). Intraoperative staple line intervention was less frequently required in the SLR group (p=0.012). While one case of postoperative anastomotic leakage was documented in the non-SLR group, no such complications were observed in the SLR group.

Conclusion: SLR represents a safe and effective adjunctive technique for FEEA in right-sided colon cancer surgery. Further validation through larger prospective studies is warranted to confirm these preliminary results.