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Effect of intracorporeal anastomosis on postoperative ileus after laparoscopic right colectomy

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Affiliated Author(s)
배성욱정운경백성규손영길
Alternative Author(s)
Bae, Sung UkJeong, Woon KyungBaek, Seong KyuSon, Young Gil
Journal Title
Ann Surg Treat Res
ISSN
2288-6796
Issued Date
2023
Keyword
IleusLaparoscopyMultivariate analysisRisk factorsSurgical anastomosis
Abstract
Purpose:
Laparoscopic right colectomy (LRC) with extracorporeal anastomosis (ECA) remains the most widely adopted technique despite mounting evidence that intracorporeal anastomosis (ICA) offers several advantages. This study aimed to compare the postoperative outcomes of ICA and ECA and to investigate the effect of ICA on postoperative ileus after LRC.

Methods:
This retrospective study included 45 patients who underwent ICA and 63 who underwent ECA in LRC for right-sided colonic diseases between January 2015 and December 2019.

Results:
There were no significant differences in total operation time, blood loss, total length of incisions, tolerance of diet, postoperative pain score on postoperative days 1 and 2, or length of hospital stays between the 2 groups. However, the ICA group had a significantly shorter time to first flatus passage (3.0 ± 0.9 days vs. 3.8 ± 1.9 days, P = 0.013). The rate of postoperative ileus was significantly higher in the ECA group (2.2% vs. 14.3%, P = 0.033); however, there was no significant difference in the overall morbidity within 30 days after surgery. Multivariate logistic regression analysis showed that the ECA technique (odds ratio [OR], 0.098; 95% confidence interval [CI]; 0.011-0.883, P = 0.038) and previous abdominal operation (OR, 5.269; 95% CI, 1.193-23.262; P = 0.028) were independent risk factors for postoperative ileus.

Conclusion:
The postoperative outcomes of patients who underwent LRC with ICA or ECA were comparable, and ICA could reduce the incidence of postoperative ileus after LRC compared with ECA.
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2288-6796
DOI
10.4174/astr.2023.104.3.156
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44793
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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