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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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 |
format | Article |
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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).</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 & 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”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-a7dedb54944eec738c440a1b078a432d9389001713ad68240b405c91954ffd293</citedby><cites>FETCH-LOGICAL-c540t-a7dedb54944eec738c440a1b078a432d9389001713ad68240b405c91954ffd293</cites><orcidid>0000-0001-9255-3312</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-019-07255-2$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-019-07255-2$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31741153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><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><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><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><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).</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 & 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 & 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 & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anania, Gabriele</au><au>Agresta, Ferdinando</au><au>Artioli, Elena</au><au>Rubino, Serena</au><au>Resta, Giuseppe</au><au>Vettoretto, Nereo</au><au>Petz, Wanda Luisa</au><au>Bergamini, Carlo</au><au>Arezzo, Alberto</au><au>Valpiani, Giorgia</au><au>Morotti, Chiara</au><au>Silecchia, Gianfranco</au><aucorp>SICE CoDIG (Colon Dx Italian Group)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>34</volume><issue>11</issue><spage>4788</spage><epage>4800</epage><pages>4788-4800</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>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).</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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