Intracorporeal versus extracorporeal anastomosis in segmental resections for colon cancer : a retrospective cohort study of 328 patients
(2023) In Langenbeck's Archives of Surgery 408. p.1-7- Abstract
PURPOSE: The intracorporeal anastomosis (IA) technique possibly results in enhanced recovery and reduced morbidity rates compared to the extracorporeal anastomosis (EA) technique. This study compared the short-term morbidity rates of IA versus EA in segmental resections for colon cancer.
METHOD: We performed a retrospective cohort study of consecutive patients from 2015 to 2020 using the IA or EA technique at a single Danish colorectal center. Comparative outcomes of interest were surgical efficacy and short-term morbidity rates. An inverse probability of treatment weighting (IPTW) analysis of clinically relevant outcomes was conducted to explore potential baseline confounding.
RESULTS: We included 328 patients, 129 in the... (More)
PURPOSE: The intracorporeal anastomosis (IA) technique possibly results in enhanced recovery and reduced morbidity rates compared to the extracorporeal anastomosis (EA) technique. This study compared the short-term morbidity rates of IA versus EA in segmental resections for colon cancer.
METHOD: We performed a retrospective cohort study of consecutive patients from 2015 to 2020 using the IA or EA technique at a single Danish colorectal center. Comparative outcomes of interest were surgical efficacy and short-term morbidity rates. An inverse probability of treatment weighting (IPTW) analysis of clinically relevant outcomes was conducted to explore potential baseline confounding.
RESULTS: We included 328 patients, 129 in the EA and 199 in the IA groups. There was no significant difference in preoperative baseline characteristics between the two groups. The rate of overall surgical (16% in both groups, p = 1.000) and medical complications (EA: 25 (19%) vs. IA: 27 (14%), p = 0.167) was comparable for both groups. The IA technique did not cause a reduction in operative time (EA: 127.0 min [103.0-171.0] vs. IA: 134.0 min [110.0-164.0], p = 0.547). The IPTW analysis indicated that having an IA caused a reduction in the rate of major surgical complications (RRR
adjusted = 0.45, 95%CI [0.29-0.69], p = 0.000).
CONCLUSION: Adopting IA for colon cancer resulted in similar overall morbidity rates without increasing the duration of the surgical procedure compared to EA. The IA technique had a probable protective effect against developing severe surgical complications. However, this must be interpreted cautiously, limited by the retrospective study design.
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- author
- Cuk, Pedja ; Büyükuslu, Musa ; Möller, Sören ; Verwaal, Victor Jilbert LU ; Al-Najami, Issam and Ellebæk, Mark Bremholm
- organization
- publishing date
- 2023-05-31
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Humans, Retrospective Studies, Colectomy/methods, Treatment Outcome, Laparoscopy/methods, Colonic Neoplasms/surgery, Anastomosis, Surgical/methods
- in
- Langenbeck's Archives of Surgery
- volume
- 408
- article number
- 219
- pages
- 1 - 7
- publisher
- Springer
- external identifiers
-
- scopus:85160862309
- pmid:37256466
- ISSN
- 1435-2451
- DOI
- 10.1007/s00423-023-02946-w
- language
- English
- LU publication?
- yes
- additional info
- © 2023. The Author(s).
- id
- bea89139-31a9-4997-91b6-498f03ad7ec3
- date added to LUP
- 2023-06-11 16:27:54
- date last changed
- 2024-04-19 22:44:48
@article{bea89139-31a9-4997-91b6-498f03ad7ec3,
abstract = {{<p>PURPOSE: The intracorporeal anastomosis (IA) technique possibly results in enhanced recovery and reduced morbidity rates compared to the extracorporeal anastomosis (EA) technique. This study compared the short-term morbidity rates of IA versus EA in segmental resections for colon cancer.</p><p>METHOD: We performed a retrospective cohort study of consecutive patients from 2015 to 2020 using the IA or EA technique at a single Danish colorectal center. Comparative outcomes of interest were surgical efficacy and short-term morbidity rates. An inverse probability of treatment weighting (IPTW) analysis of clinically relevant outcomes was conducted to explore potential baseline confounding.</p><p>RESULTS: We included 328 patients, 129 in the EA and 199 in the IA groups. There was no significant difference in preoperative baseline characteristics between the two groups. The rate of overall surgical (16% in both groups, p = 1.000) and medical complications (EA: 25 (19%) vs. IA: 27 (14%), p = 0.167) was comparable for both groups. The IA technique did not cause a reduction in operative time (EA: 127.0 min [103.0-171.0] vs. IA: 134.0 min [110.0-164.0], p = 0.547). The IPTW analysis indicated that having an IA caused a reduction in the rate of major surgical complications (RRR<br>
adjusted = 0.45, 95%CI [0.29-0.69], p = 0.000).<br>
</p><p>CONCLUSION: Adopting IA for colon cancer resulted in similar overall morbidity rates without increasing the duration of the surgical procedure compared to EA. The IA technique had a probable protective effect against developing severe surgical complications. However, this must be interpreted cautiously, limited by the retrospective study design.</p>}},
author = {{Cuk, Pedja and Büyükuslu, Musa and Möller, Sören and Verwaal, Victor Jilbert and Al-Najami, Issam and Ellebæk, Mark Bremholm}},
issn = {{1435-2451}},
keywords = {{Humans; Retrospective Studies; Colectomy/methods; Treatment Outcome; Laparoscopy/methods; Colonic Neoplasms/surgery; Anastomosis, Surgical/methods}},
language = {{eng}},
month = {{05}},
pages = {{1--7}},
publisher = {{Springer}},
series = {{Langenbeck's Archives of Surgery}},
title = {{Intracorporeal versus extracorporeal anastomosis in segmental resections for colon cancer : a retrospective cohort study of 328 patients}},
url = {{http://dx.doi.org/10.1007/s00423-023-02946-w}},
doi = {{10.1007/s00423-023-02946-w}},
volume = {{408}},
year = {{2023}},
}