Impact of intracorporeal anastomosis on surgical time and anastomotic leak rate in patients undergoing Videolaparoscopic Ileocolectomy
Author(s): Marcos Figueiredo Costa, Jairo Sebastian Astudillo Vallejo, Fábio Lopes de Queiroz, Lucas Alves Bessa Cardoso, Ricardo Cembranelli Teixeira, Helena Flávia Cuba de Almada Lima, José Marcos Coelho, Daniel Maurício Londoño Estrada
Introduction: Advances in surgical instruments and surgeon proficiency have facilitated the adoption of completely laparoscopic procedures, enhancing the benefits of minimally invasive surgery. Intracorporeal (IC) anastomosis demands a higher level of technical skill, a steeper learning curve, and extended training. While some published studies suggest the superiority of IC anastomosis, the existing evidence is inconclusive with heterogeneous conclusions. Thus this study aims to evaluate the impact of the IC anastomosis on surgical time, anastomotic leak (AL) rate in patients undergoing laparoscopic right colectomy.
Methods: Retrospective cohort study with 234 patients who underwent laparoscopic ileocolectomy between January 2014 and March 2021. Patients were categorized into two groups: IC anastomosis and extracorporeal (EC) anastomosis and analyzed for: Surgical time, AL rate in patients after laparoscopic right colectomy.
Results: Surgical time was significantly shorter in the extracorporeal anastomosis group (198 min vs. 260 min; p<0.001). The overall AL rate after ileocolic anastomosis was 3.1%, with a notably higher incidence in the IC anastomosis group (7.2% vs. 1.3%, p=0.021). Univariate analysis identified IC anastomosis as the sole independent risk factor for AL (OR: 6.13, p=0.033).
Conclusions: Patients undergoing ileocolectomy with intracorporeal anastomosis exhibited prolonged surgical times and a higher incidence of AL compared to those undergoing EC anastomosis.