Shinsuke Masubuchi1*, Junji Okuda2, Hiroki Hamamoto1, Masatsugu Ishii1, Wataru Osumi1, Masashi Yamamoto1, Yoshihiro Inoue1, Keitaro Tanaka1 and Kazuhisa Uchiyama1
1Department of General and Gastroenterological Surgery, Osaka Medical College, Japan
2Department of Cancer Center, Osaka Medical College, Japan
Background: Laparoscopic colectomy for colon cancer with Intracorporeal Anastomosis (IA) is a procedure that is being increasingly performed. The short-term outcomes of IA were compared with those of Extracorporeal Anastomosis (EA) in laparoscopic left colectomy for left-side colon cancer. Methods: A series of 98 patients undergoing laparoscopic left colectomy for left-side colon cancer from May 2013 to November 2017 in our institution were retrospectively analyzed. Propensity score matching analysis was performed to overcome patient selection bias between the two surgical techniques. Results: After propensity score matching, 20 patients in the IA group and 20 patients in the EA group were compared. There were no significant differences in operative time, estimated blood loss, complications, and postoperative course. The mini-laparotomy incision was significantly shorter in the IA than in the EA group (3.3 vs. 5.0 cm, p <0.01). Although takedown of the splenic flexure to fully mobilize the left hemicolon was mandatory in the EA group, it was performed in only 5 patients (25.0%) in the IA group. Furthermore, the number of days to first flatus was shorter in the IA group than in the EA group (1 vs. 2 days, p <0.05). Conclusions: A totally laparoscopic colectomy with IA for the treatment of left-side colon cancer is technically feasible and can be performed with good cosmetic outcomes and decreased time to first flatus, suggesting faster recovery. Further investigations are needed to assess the oncological outcomes of this technique.
Masubuchi S, Okuda J, Hamamoto H, Ishii M, Osumi W, Yamamoto M, et al. Intracorporeal Versus Extracorporeal Anastomosis in Laparoscopic Left Colectomy Forleft-Side Colon Cancer: A Retrospective Study. Clin Surg. 2019; 4: 2506.