BACKGROUND/AIMS: To compare short- and long-term outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in obese (body mass index >30 kg/m2) patients. PATIENTS AND METHODS: Sixty-four consecutive obese patients who underwent laparoscopic (LPS) right colectomy with IA were matched with 64 patients who underwent LPS right colectomy with EA. Intraoperative variables, short-term outcomes, readmission rates, and morbidity and mortality rates were analyzed along with long-term outcomes. RESULTS: Conversion to open surgery occurred in 4 patients in the IA group and 11 patients in the EA group (p = 0.097). The overall 30-day morbidity rate was 29.6% in the IA and 32.8% in the EA (p = 0.70). No 30-day mortality occurred. Anastomotic leak occurred in 4.7% of patients in the IA group vs. 7.8% in the EA group (p = 0.71). In the IA group, an earlier recovery of bowel function was observed (p = 0.01). No differences were observed with respect to the length of stay and reoperation rate. No 30-day readmission occurred in the IA compared to 5 patients readmitted in the EA group (p = 0.058). A higher incidence of incisional hernia was observed in the EA group (p = 0.033). CONCLUSION: IA in obese patients is associated with similar short-term outcomes, lower incidence of incisional hernias, and might possibly reduce the risk of hospital readmission.
BACKGROUND/AIMS: To compare short- and long-term outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in obese (body mass index >30 kg/m2) patients. PATIENTS AND METHODS: Sixty-four consecutive obesepatients who underwent laparoscopic (LPS) right colectomy with IA were matched with 64 patients who underwent LPS right colectomy with EA. Intraoperative variables, short-term outcomes, readmission rates, and morbidity and mortality rates were analyzed along with long-term outcomes. RESULTS: Conversion to open surgery occurred in 4 patients in the IA group and 11 patients in the EA group (p = 0.097). The overall 30-day morbidity rate was 29.6% in the IA and 32.8% in the EA (p = 0.70). No 30-day mortality occurred. Anastomotic leak occurred in 4.7% of patients in the IA group vs. 7.8% in the EA group (p = 0.71). In the IA group, an earlier recovery of bowel function was observed (p = 0.01). No differences were observed with respect to the length of stay and reoperation rate. No 30-day readmission occurred in the IA compared to 5 patients readmitted in the EA group (p = 0.058). A higher incidence of incisional hernia was observed in the EA group (p = 0.033). CONCLUSION: IA in obesepatients is associated with similar short-term outcomes, lower incidence of incisional hernias, and might possibly reduce the risk of hospital readmission.
Authors: M Milone; U Elmore; M E Allaix; P P Bianchi; A Biondi; L Boni; U Bracale; E Cassinotti; G Ceccarelli; F Corcione; D Cuccurullo; M Degiuli; Nicolò De Manzini; D D'Ugo; G Formisano; M Manigrasso; M Morino; S Palmisano; R Persiani; R Reddavid; F Rondelli; N Velotti; R Rosati; Giovanni Domenico De Palma Journal: Surg Endosc Date: 2019-04-22 Impact factor: 4.584
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Authors: Antonio Sciuto; Giovanni Merola; Giovanni D De Palma; Maurizio Sodo; Felice Pirozzi; Umberto M Bracale; Umberto Bracale Journal: World J Gastroenterol Date: 2018-06-07 Impact factor: 5.742
Authors: Andrzej P Kwiatkowski; Gabriela Stępińska; Edward Stanowski; Krzysztof Paśnik; Michal R Janik Journal: Wideochir Inne Tech Maloinwazyjne Date: 2019-01-30 Impact factor: 1.195
Authors: Michele Manigrasso; Nunzio Velotti; Federica Calculli; Giovanni Aprea; Katia Di Lauro; Enrico Araimo; Ugo Elmore; Sara Vertaldi; Pietro Anoldo; Mario Musella; Marco Milone; Loredana Maria Sosa Fernandez; Francesco Milone; Giovanni Domenico De Palma Journal: Open Med (Wars) Date: 2019-08-09