The safety of intracorporeal anastomoses after right colectomy during the learning curve
https://doi.org/10.17650/2686-9594-2020-10-1-37-42
Abstract
Objective: to asses safety of installation intracorporeal anastomosis (ICA) in routine practice at learning curve period.
Materials and methods. The results of treatment of 102 patients during 2019 were retrospectively analyzed, of which 64 were operated by an expert and 38 passing the ICA learning curve.
Results. The operation time was shorter for the expert (145 minutes versus 210 minutes, p <0.05), there was no statistical difference in pathomorphological measurements, the number of lymph nodes removed was oncologically acceptable and did not differ significantly in the two groups. The total number of complications was 25.2 % for all patients, and Clavien–Dindo class IIIB complication rate was also the same (3.2 % vs 2.6 %, p >0.05).
Conclusions. The introduction of ICA in right colectomy into routine practice at the stage of passing the learning curve is safe and applicable.
About the Authors
P. V. Melnikov
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
I. I. Chernikovskiy
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
D. Yu. Kanner
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
N. V. Savanovich
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
A. V. Gavrilyukov
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
D. A. Chernikov
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
L. I. Markushin
Moscow City Oncology Hospital № 62
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
Russian Federation
Russia, 143423 Moscow region, Krasnogorskiy district, Istra Settlement, 27
References
1. The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350(20):2050–9. DOI: 10.1056/NEJMoa032651.
2. Dijkstra F.A., Bosker R.J., Veeger N.J. et al. Procedural key steps in laparoscopic colorectal surgery, consensus through Delphi methodology. Surg Endosc 2015;29(9):2620–7. DOI: 10.1007/s00464-014-3979-7.
3. Ricci C., Casadei R., Alagna V. et al. A critical and comprehensive systematic review and meta-analysis of studies comparing intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy. Langenbecks Arch Surg 2017;402(3):417–27. DOI: 10.1007/s00423-016-1509-x.
4. Petersson J., Koedam T.W., Bonjer H.J. et al. Colorectal cancer laparoscopic or open resection (color) II study group. Bowel obstruction and ventral hernia after laparoscopic versus open surgery for rectal cancer in a randomized trial (COLOR II). Ann Surg 2019;269(1):53–7. DOI: 10.1097/SLA.0000000000002790.
5. Jensen K.K., Nordholm-Carstensen A., Krarup P.M. et al. Incidence of incisional hernia repair after laparoscopic compared to open resection of colonic cancer: a nationwide analysis of 17,717 patients. World J Surg 2020. DOI: 10.1007/s00268-020-05375-8.
6. Udayasiri D.K., Skandarajah A., Hayes I.P. Laparoscopic compared with open resection for colorectal cancer and long-term incidence of adhesional intestinal obstruction and incisional hernia: a systematic review and metaanalysis. Dis Colon Rectum 2020;63(1):101–12. DOI: 10.1097/DCR.0000000000001540.
7. Cano-Valderrama O., Sanz-López R., Domínguez-Serrano I. et al. Extraction-site incisional hernia after laparoscopic colorectal surgery: should we carry out a study about prophylactic mesh closure? Surg Endosc 2019. DOI: 10.1007/s00464-019-07194-y.
8. Varathan N., Rotigliano N., Nocera F. et al. Left lower transverse incision versus Pfannenstiel–Kerr incision for specimen extraction in laparoscopic sigmoidectomy: a match pair analysis. Int J Colorectal Dis 2020;35(2):233–8. DOI: 10.1007/s00384-019-03444-6.
9. Singh R., Omiccioli A., Hegge S. et al. Does the extraction-site location in laparoscopic colorectal surgery have an impact on incisional hernia rates? Surg Endosc 2008;22:2596–600. DOI: 10.1007/s00464-008-9845-8.
10. Ma B., Huang X.Z., Gao P. et al. Laparoscopic resection with natural orifice specimen extraction versus conventional laparoscopy for colorectal disease: a metaanalysis. J Colorectal Dis 2015;30(11): 1479–88. DOI: 10.1007/s00384-015-2337-0.
11. Jamali F.R., Soweid A.M., Dimassi H. et al. Evaluating the degree of difficulty of laparoscopic colorectal surgery. Arch Surg 2008;143:762–7. DOI: 10.1001/archsurg.143.8.762.
12. Marchesi F., Pinna F., Percalli L. et al. Totally laparoscopic right colectomy: theoretical and practical advantages over the laparo-assisted approach. J Laparoendosc Adv Surg Tech A 2013;23:418–24. DOI: 10.1089/lap.2012.0420.
13. Cleary R.K., Kassir A., Johnson C.S. et al. Intracorporeal versus extracorporeal anastomosis for minimally invasive right colectomy: a multi-center propensity score-matches comparison of outcomes. PLoS One 2018;13:e020627.
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