Intracorporeal versus extracorporeal anastomosis for right colectomy does not affect gastrointestinal recovery within an enhanced recovery after surgery program.

摘要: Introduction Delayed gastrointestinal (GI) recovery remains a significant morbidity after colorectal surgery. Intracorporeal anastomosis for right colectomy may hasten GI recovery. Therefore, the objective of this study was to determine effect intracorporeal versus extracorporeal on elective laparoscopic within an established ERAS program. Methods Adult patients undergoing at single high-volume institution from 07/2014 12/2018 were reviewed. Patients divided into two groups: (IC) and (EC). The primary outcome time GI-3 defined as days tolerance solid diet first flatus/bowel movement. Prolonged postoperative ileus (PPOI) not met by day 4. Secondary outcomes length stay (LOS) overall 30-day complications. Sensitivity analysis performed using coarsened exact matching account unmeasured confounding. Multiple regression Cox proportional hazard model identify predictors Results A total 346 reviewed, which 226 included (71IC, 155EC). Patient characteristics well balanced between mean age 64.9 years (SD 15.9), BMI 26.3 5.7), 38.1% had ASA ≥ 3, 78.3% underwent surgery neoplasms. IC associated with longer operative duration (165 min 40); 144 48), p = 0.002). There no difference in median (IC 2 [IQR1-2]; EC [IQR2-3], 0.135). incidence PPOI 8.5%; 10.3%, 0.659), superficial SSI (4.2% vs. 5.8%, 0.757), deep (2.8% 5.2%, 0.729), LOS (3 [IQR 2-4] 3 3-5], 0.059) also similar. On multivariate analysis, did independently predict faster (HR 0.98, 95% CI 0.71-1.34). Similar results observed matched cohort (185 (61IC, 124EC)). Conclusion In study, or reduced complication rate compared anastomosis. Longer term studies be required potential benefits