Intracorporeal anastomosis leads to a quicker recovery following both laparoscopic and robotic right hemicolectomy
EAES Academy. Kitow J. 07/05/22; 363118; P163
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Intracorporeal anastomosis leads to a quicker recovery following both laparoscopic and robotic right hemicolectomy
J. Kitow, N. Went, K. M. Zoetzl, D. Birrer, A. Rickenbacher, M. Turina
Abstract:
Aims:
In laparoscopic right hemicolectomy, extracorporeal anastomosis (ECA) has prevailed due to the complexity of performing laparoscopic intracorporeal sutures. Following robotic hemicolectomy, intracorporeal anastomosis (RICA) has gained more widespread acceptance, presumably due to the greater ease of intracorporeal suturing.
Our study tests the hypothesis whether RICA offers improved short-term postoperative outcomes compared to laparoscopic extracorporeal anastomosis (LECA) in right hemicolectomy.
Methods:
A retrospective analysis of our institutional database was conducted. All patients undergoing either robotic or laparoscopic right hemicolectomy for cancer between 2016 and May 2021 by one of two colorectal surgeons were included. Primary outcomes were days to flatus, days to soft diet and length of hospital stay.
Secondary outcomes included length of operation, conversion rate, and the number of lymph nodes harvested.
Results:
The study included 73 patients (41 in the robotic group, (RICA=21, RECA =20) and 32 in the laparoscopic group (LICA=5, LECA =27)).
Time to soft diet was shorter following both robotic and laparoscopic intracorporeal anastomosis, compared to any extracorporeal anastomosis (2 vs 2.9 days; P= 0.04)
Duration of hospital stay was shorter with RICA compared to LECA (days=6.1 vs. days=8.6 P= 0.0311). Lymph node yield was higher in both ICA groups compared to the ECA groups (26 versus 20, P = 0.0121),) and median operative time was significantly longer when performing an intracorporeal anastomosis (RICA: 252min, LICA 225 min vs LECA 189min, P <0.01).
There were no significant differences in days to full mobility, days to flatus, conversions, readmission rates and reoperations.
Conclusion:
Robotic intracorporeal anastomosis following right hemicolectomy is associated with shorter recovery and hospital stay compared to resections with extracorporeal anastomoses. In addition, a trend to higher lymph node yields was observed which may be associated with improved oncologic outcomes. This study adds to previous reports documenting the superiority of the robotic approach in select subgroups of colorectal cancer patients, which should be identified more clearly in subsequent studies.
J. Kitow, N. Went, K. M. Zoetzl, D. Birrer, A. Rickenbacher, M. Turina
Abstract:
Aims:
In laparoscopic right hemicolectomy, extracorporeal anastomosis (ECA) has prevailed due to the complexity of performing laparoscopic intracorporeal sutures. Following robotic hemicolectomy, intracorporeal anastomosis (RICA) has gained more widespread acceptance, presumably due to the greater ease of intracorporeal suturing.
Our study tests the hypothesis whether RICA offers improved short-term postoperative outcomes compared to laparoscopic extracorporeal anastomosis (LECA) in right hemicolectomy.
Methods:
A retrospective analysis of our institutional database was conducted. All patients undergoing either robotic or laparoscopic right hemicolectomy for cancer between 2016 and May 2021 by one of two colorectal surgeons were included. Primary outcomes were days to flatus, days to soft diet and length of hospital stay.
Secondary outcomes included length of operation, conversion rate, and the number of lymph nodes harvested.
Results:
The study included 73 patients (41 in the robotic group, (RICA=21, RECA =20) and 32 in the laparoscopic group (LICA=5, LECA =27)).
Time to soft diet was shorter following both robotic and laparoscopic intracorporeal anastomosis, compared to any extracorporeal anastomosis (2 vs 2.9 days; P= 0.04)
Duration of hospital stay was shorter with RICA compared to LECA (days=6.1 vs. days=8.6 P= 0.0311). Lymph node yield was higher in both ICA groups compared to the ECA groups (26 versus 20, P = 0.0121),) and median operative time was significantly longer when performing an intracorporeal anastomosis (RICA: 252min, LICA 225 min vs LECA 189min, P <0.01).
There were no significant differences in days to full mobility, days to flatus, conversions, readmission rates and reoperations.
Conclusion:
Robotic intracorporeal anastomosis following right hemicolectomy is associated with shorter recovery and hospital stay compared to resections with extracorporeal anastomoses. In addition, a trend to higher lymph node yields was observed which may be associated with improved oncologic outcomes. This study adds to previous reports documenting the superiority of the robotic approach in select subgroups of colorectal cancer patients, which should be identified more clearly in subsequent studies.
Intracorporeal anastomosis leads to a quicker recovery following both laparoscopic and robotic right hemicolectomy
J. Kitow, N. Went, K. M. Zoetzl, D. Birrer, A. Rickenbacher, M. Turina
Abstract:
Aims:
In laparoscopic right hemicolectomy, extracorporeal anastomosis (ECA) has prevailed due to the complexity of performing laparoscopic intracorporeal sutures. Following robotic hemicolectomy, intracorporeal anastomosis (RICA) has gained more widespread acceptance, presumably due to the greater ease of intracorporeal suturing.
Our study tests the hypothesis whether RICA offers improved short-term postoperative outcomes compared to laparoscopic extracorporeal anastomosis (LECA) in right hemicolectomy.
Methods:
A retrospective analysis of our institutional database was conducted. All patients undergoing either robotic or laparoscopic right hemicolectomy for cancer between 2016 and May 2021 by one of two colorectal surgeons were included. Primary outcomes were days to flatus, days to soft diet and length of hospital stay.
Secondary outcomes included length of operation, conversion rate, and the number of lymph nodes harvested.
Results:
The study included 73 patients (41 in the robotic group, (RICA=21, RECA =20) and 32 in the laparoscopic group (LICA=5, LECA =27)).
Time to soft diet was shorter following both robotic and laparoscopic intracorporeal anastomosis, compared to any extracorporeal anastomosis (2 vs 2.9 days; P= 0.04)
Duration of hospital stay was shorter with RICA compared to LECA (days=6.1 vs. days=8.6 P= 0.0311). Lymph node yield was higher in both ICA groups compared to the ECA groups (26 versus 20, P = 0.0121),) and median operative time was significantly longer when performing an intracorporeal anastomosis (RICA: 252min, LICA 225 min vs LECA 189min, P <0.01).
There were no significant differences in days to full mobility, days to flatus, conversions, readmission rates and reoperations.
Conclusion:
Robotic intracorporeal anastomosis following right hemicolectomy is associated with shorter recovery and hospital stay compared to resections with extracorporeal anastomoses. In addition, a trend to higher lymph node yields was observed which may be associated with improved oncologic outcomes. This study adds to previous reports documenting the superiority of the robotic approach in select subgroups of colorectal cancer patients, which should be identified more clearly in subsequent studies.
J. Kitow, N. Went, K. M. Zoetzl, D. Birrer, A. Rickenbacher, M. Turina
Abstract:
Aims:
In laparoscopic right hemicolectomy, extracorporeal anastomosis (ECA) has prevailed due to the complexity of performing laparoscopic intracorporeal sutures. Following robotic hemicolectomy, intracorporeal anastomosis (RICA) has gained more widespread acceptance, presumably due to the greater ease of intracorporeal suturing.
Our study tests the hypothesis whether RICA offers improved short-term postoperative outcomes compared to laparoscopic extracorporeal anastomosis (LECA) in right hemicolectomy.
Methods:
A retrospective analysis of our institutional database was conducted. All patients undergoing either robotic or laparoscopic right hemicolectomy for cancer between 2016 and May 2021 by one of two colorectal surgeons were included. Primary outcomes were days to flatus, days to soft diet and length of hospital stay.
Secondary outcomes included length of operation, conversion rate, and the number of lymph nodes harvested.
Results:
The study included 73 patients (41 in the robotic group, (RICA=21, RECA =20) and 32 in the laparoscopic group (LICA=5, LECA =27)).
Time to soft diet was shorter following both robotic and laparoscopic intracorporeal anastomosis, compared to any extracorporeal anastomosis (2 vs 2.9 days; P= 0.04)
Duration of hospital stay was shorter with RICA compared to LECA (days=6.1 vs. days=8.6 P= 0.0311). Lymph node yield was higher in both ICA groups compared to the ECA groups (26 versus 20, P = 0.0121),) and median operative time was significantly longer when performing an intracorporeal anastomosis (RICA: 252min, LICA 225 min vs LECA 189min, P <0.01).
There were no significant differences in days to full mobility, days to flatus, conversions, readmission rates and reoperations.
Conclusion:
Robotic intracorporeal anastomosis following right hemicolectomy is associated with shorter recovery and hospital stay compared to resections with extracorporeal anastomoses. In addition, a trend to higher lymph node yields was observed which may be associated with improved oncologic outcomes. This study adds to previous reports documenting the superiority of the robotic approach in select subgroups of colorectal cancer patients, which should be identified more clearly in subsequent studies.
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