Kang-Haeng Lee1, Sung-Min Lee2, Heung-Kwon Oh1, Soo-Young Lee1, Myong Hoon Ihn1, Duck-Woo Kim1, Sung-Bum Kang3. 1. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Republic of Korea. 2. Department of Surgery, Chung Hospital, 2968 Sujin 2-dong, Sujeong-gu, Seongnam, 461-872, Republic of Korea. 3. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, 463-707, Republic of Korea. kangsb@snubh.org.
Abstract
BACKGROUND: Stapled technique for ileocolic anastomosis is largely supported in previous studies. However, standard anastomotic configuration is not conclusive and studies are limited. This study aims to compare postoperative outcomes between side to side (S-S) and end to side (E-S) stapled anastomosis after laparoscopic right hemicolectomy underenhanced recovery program (ERP). METHODS: Between October 2009 and November 2012, 89 patients (46 in S-S group, 43 in E-S group) who underwent laparoscopic right hemicolectomy for colon cancer and managed with ERP were included in the study. Recovery time and cumulative recovery rates, the length of hospital stays, complication rates were analyzed to compare both configurations. RESULTS: The recovery time were not different between groups (S-S group, 135 hours [84-183.5] vs E-S group, 117 hours [94-143]; P = 0.349). Difference of cumulative recovery rates were observed in postoperative day 7 (S-S group, 71.7 % vs E-S group, 93.0 %; P = 0.019). The postoperative hospital stay were shorter in E-S group (S-S, 7 days [6-9] vs E-S, 6 days [5-7]; P = 0.003). The overall complication rates were lower in E-S group (26.1 % vs 4.6 %; P = 0.008). Anastomotic leakage was not observed in both groups. CONCLUSIONS: E-S configuration after laparoscopic right hemicolectomy showed favorable outcomes under enhanced recovery program.
BACKGROUND: Stapled technique for ileocolic anastomosis is largely supported in previous studies. However, standard anastomotic configuration is not conclusive and studies are limited. This study aims to compare postoperative outcomes between side to side (S-S) and end to side (E-S) stapled anastomosis after laparoscopic right hemicolectomy underenhanced recovery program (ERP). METHODS: Between October 2009 and November 2012, 89 patients (46 in S-S group, 43 in E-S group) who underwent laparoscopic right hemicolectomy for colon cancer and managed with ERP were included in the study. Recovery time and cumulative recovery rates, the length of hospital stays, complication rates were analyzed to compare both configurations. RESULTS: The recovery time were not different between groups (S-S group, 135 hours [84-183.5] vs E-S group, 117 hours [94-143]; P = 0.349). Difference of cumulative recovery rates were observed in postoperative day 7 (S-S group, 71.7 % vs E-S group, 93.0 %; P = 0.019). The postoperative hospital stay were shorter in E-S group (S-S, 7 days [6-9] vs E-S, 6 days [5-7]; P = 0.003). The overall complication rates were lower in E-S group (26.1 % vs 4.6 %; P = 0.008). Anastomotic leakage was not observed in both groups. CONCLUSIONS:E-S configuration after laparoscopic right hemicolectomy showed favorable outcomes under enhanced recovery program.
Entities:
Keywords:
Enhanced recovery program; Ileocolic anastomosis; Laparoscopic surgery
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