Intra-corporeal delta-shaped anastomosis in laparoscopic right hemicolectomy for right colon cancer: A safe and effective technique

Abstract

Background and objective: Intra-corporeal delta-shaped anastomosis (IDA) is an important development in laparoscopic digestive-tract reconstruction. We applied it in laparoscopic right hemicolectomy for right colon cancer and compared the short-term outcomes between the patients treated with IDA and conventional extracorporeal anastomosis (EA). Methods: Between 1 January 2016 and 1 October 2017, 36 and 50 patients who underwent IDA and EA, respectively, were included. Data on clinicopathological characteristics, surgical outcomes, post-operative recovery and complications were collected and compared between the two groups. Results: Surgical outcomes and clinicopathological characteristics were similar between the two groups except the length of incision, which was significantly shorter in the IDA group than in the EA group (4.6 6 0.6 vs 5.6 6 0.7 cm, P < 0.001). The time to ground activities, fluid diet intake and post-operative hospitalization did not differ between the groups; however, the time to first flatus was significantly shorter in the IDA group than in the EA group (2.8 6 0.5 vs 3.2 6 0.8 days, P ¼ 0.004). The post-operative visual analogue scale for pain was lower in the IDA group than in the EA group on post-operative Day 1 (4.0 6 0.7 vs 4.5 6 1.0, P ¼ 0.002) and post-operative Day 3 (2.7 6 0.6 vs 3.4 6 0.6, P < 0.001). The surgical complication rates were 8.3 and 16.0% in the IDA and EA groups (P ¼ 0.470), respectively. No complications such as anastomotic bleeding, stenosis and leakage occurred in any patient. Conclusions: IDA is safe and feasible and shows more satisfactory short-term outcomes than EA.