Recovery after minimally invasive right colectomy with intra-corporeal anastomosis as good as extra-corporeal anastomosis

Researchers conducted the study to determine if minimally invasive right colectomy with intra-corporeal anastomosis improves postoperative recovery compared to extraanastomosis as good as extra-corporeal anastomosis.

Previous trials have shown that intracorporeal anastomosis improves postoperative recovery; however, it has not yet been evaluated in a setting with optimized perioperative care or with patient-related outcome measures.

This was a multicenter, triple-blind, randomized clinical trial at two high-volume colorectal centers with strict adherence to optimized perioperative care pathways. The patients underwent robotic right colectomy with either intracorporeal or extracorporeal anastomosis. The primary outcome was patient-reported postoperative recovery measured using the “Quality of Recovery–15” questionnaire. 

Results:

A total of 89 patients were randomized and analyzed according to the “Intention-to-treat”-principle. We found no statistically significant differences in patient-reported recovery between the groups. Postoperative pain, nausea, time to ambulation, time to first passage of flatus/stool, length of hospital stay, and pathophysiological tests showed no differences either. The duration of time to create the anastomosis was significantly longer with intracorporeal anastomosis (17 vs 13 min, P = 0.003), while all other intraoperative, postoperative, and pathology variables showed no difference.

There were no significant differences in postoperative recovery between the two groups.

Reference:

Dohrn, Niclas MD*,†; Yikilmaz, Helin BMSc†; Laursen, Magnus BMSc*; Khesrawi, Faisal MD†; Clausen, Frederik Bjerg BMSc*; Sørensen, Frederik MSc‡; Jakobsen, Henrik Loft MD*; Brisling, Steffen MD†; Lykke, Jakob MD PhD*; Eriksen, Jens Ravn MD PhD†; Klein, Mads Falk MD PhD*; Gögenur, Ismail MD PhD DMSc†. Intracorporeal Versus Extracorporeal Anastomosis in Robotic Right Colectomy: A Multicenter, Triple-blind, Randomized Clinical Trial. Annals of Surgery 276(5):p e294-e301, November 2022. | DOI: 10.1097/SLA.0000000000005254