Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a coh...

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Veröffentlicht in:Surgical endoscopy 2020-11, Vol.34 (11), p.4788-4800
Hauptverfasser: Anania, Gabriele, Agresta, Ferdinando, Artioli, Elena, Rubino, Serena, Resta, Giuseppe, Vettoretto, Nereo, Petz, Wanda Luisa, Bergamini, Carlo, Arezzo, Alberto, Valpiani, Giorgia, Morotti, Chiara, Silecchia, Gianfranco
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container_end_page 4800
container_issue 11
container_start_page 4788
container_title Surgical endoscopy
container_volume 34
creator Anania, Gabriele
Agresta, Ferdinando
Artioli, Elena
Rubino, Serena
Resta, Giuseppe
Vettoretto, Nereo
Petz, Wanda Luisa
Bergamini, Carlo
Arezzo, Alberto
Valpiani, Giorgia
Morotti, Chiara
Silecchia, Gianfranco
description Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).
doi_str_mv 10.1007/s00464-019-07255-2
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The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-019-07255-2</identifier><identifier>PMID: 31741153</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Abdominal Surgery ; Body mass index ; Colon ; Comorbidity ; Endoscopy ; Gastroenterology ; Gynecology ; Hemorrhage ; Hepatology ; Hospitals ; Laparoscopy ; Lymphatic system ; Medicine ; Medicine &amp; Public Health ; Multivariate analysis ; Narcotics ; Overweight ; Patients ; Proctology ; Robotic surgery ; Surgery ; Surgical outcomes ; Surgical techniques</subject><ispartof>Surgical endoscopy, 2020-11, Vol.34 (11), p.4788-4800</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Body mass index</subject><subject>Colon</subject><subject>Comorbidity</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hemorrhage</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Laparoscopy</subject><subject>Lymphatic system</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Multivariate analysis</subject><subject>Narcotics</subject><subject>Overweight</subject><subject>Patients</subject><subject>Proctology</subject><subject>Robotic surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Surgical techniques</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>BENPR</sourceid><recordid>eNp9UstuEzEUtRCIlsAPsECW2JSFwc_MmEUlFAWIFMGiZW05npvEZWY82J5A_4Z_4WP4DZwmFMqC1ZV9j8895_og9JTRl4zS6lWiVE4loUwTWnGlCL-HTpkUnHDO6vvolGpBCa-0PEGPUrqiBa-ZeohOBKskY0qcop9LO9gYkguDdzj6zTbjLXTehRZcDt31a5y3gC8Wszk-uwjOQ_7xHS-ybb3tLW48nm19HOPGWzzvmyORxYA_jGEH-BJcH9qw8fAC95C_hvgZD2XeUNh96efobYtDjxnnCjubIGEXuqLJ9xvs-xxtOcchRCi4HcQ0Jgzf7l77FgIpiouD5BsgOZB9xUVhKh5C8ukxerC2bYInxzpBn97OL2fvyfLju8XszZI4JWkmtmqgWSmppQRwlaidlNSyFa1qWxbbaFFrSlnFhG2mNZd0Jalymmkl1-uGazFB5wfeYVx10DjYO2jNEH1n47UJ1pu7nd5vzSbsTKUqLoQqBGdHghi-jJCy6Xxy0La2hzAmwwVTeqo5ZQX6_B_oVRhjX-wZXnHNay5uUPyAcmXtKcL6VgyjZp8jc8iRKTkyNzkqMybo2d82bp_8Dk4BiAMgDfufgvhn9n9ofwH_tdkL</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Anania, Gabriele</creator><creator>Agresta, Ferdinando</creator><creator>Artioli, Elena</creator><creator>Rubino, Serena</creator><creator>Resta, Giuseppe</creator><creator>Vettoretto, Nereo</creator><creator>Petz, Wanda Luisa</creator><creator>Bergamini, Carlo</creator><creator>Arezzo, Alberto</creator><creator>Valpiani, Giorgia</creator><creator>Morotti, Chiara</creator><creator>Silecchia, Gianfranco</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-9255-3312</orcidid></search><sort><creationdate>20201101</creationdate><title>Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis</title><author>Anania, Gabriele ; Agresta, Ferdinando ; Artioli, Elena ; Rubino, Serena ; Resta, Giuseppe ; Vettoretto, Nereo ; Petz, Wanda Luisa ; Bergamini, Carlo ; Arezzo, Alberto ; Valpiani, Giorgia ; Morotti, Chiara ; Silecchia, Gianfranco</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-a7dedb54944eec738c440a1b078a432d9389001713ad68240b405c91954ffd293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Body mass index</topic><topic>Colon</topic><topic>Comorbidity</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hemorrhage</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Laparoscopy</topic><topic>Lymphatic system</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Multivariate analysis</topic><topic>Narcotics</topic><topic>Overweight</topic><topic>Patients</topic><topic>Proctology</topic><topic>Robotic surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Surgical techniques</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anania, Gabriele</creatorcontrib><creatorcontrib>Agresta, Ferdinando</creatorcontrib><creatorcontrib>Artioli, Elena</creatorcontrib><creatorcontrib>Rubino, Serena</creatorcontrib><creatorcontrib>Resta, Giuseppe</creatorcontrib><creatorcontrib>Vettoretto, Nereo</creatorcontrib><creatorcontrib>Petz, Wanda Luisa</creatorcontrib><creatorcontrib>Bergamini, Carlo</creatorcontrib><creatorcontrib>Arezzo, Alberto</creatorcontrib><creatorcontrib>Valpiani, Giorgia</creatorcontrib><creatorcontrib>Morotti, Chiara</creatorcontrib><creatorcontrib>Silecchia, Gianfranco</creatorcontrib><creatorcontrib>SICE CoDIG (Colon Dx Italian Group)</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).</abstract><cop>New York</cop><pub>Springer US</pub><pmid>31741153</pmid><doi>10.1007/s00464-019-07255-2</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-9255-3312</orcidid><oa>free_for_read</oa></addata></record>
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subjects Abdomen
Abdominal Surgery
Body mass index
Colon
Comorbidity
Endoscopy
Gastroenterology
Gynecology
Hemorrhage
Hepatology
Hospitals
Laparoscopy
Lymphatic system
Medicine
Medicine & Public Health
Multivariate analysis
Narcotics
Overweight
Patients
Proctology
Robotic surgery
Surgery
Surgical outcomes
Surgical techniques
title Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis
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