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Intra-versus extracorporeal anastomosis in laparoscopic right colectomy: a meta-analysis of 3699 patients

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Abstract

Background

Laparoscopic right colectomy (LRC) has become a gold standard. However, a major current concern is still whether anastomosis should be performed extracorporeally or entirely laparoscopically. This meta-analysis assesses and compares peri- and postoperative outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in LRC.

Methods

The research used the PubMed, Embase and Cochrane databases for studies comparing IA with EA during LRC. Our main endpoint was parietal abscess. Secondary endpoints were 30-day morbidity, mortality, time to onset of gas and stools, length of stay, number of lymph nodes removed and postoperative incisional hernia rates. The MINORS criteria were used to evaluate the quality of the studies examined.

Results

Twenty-four articles comprising 3699 patients, published between 2004 and 2020, were included in this meta-analysis. After sensitivity analysis, IA was associated with a decrease in parietal abscesses (OR 0.526, IC 0.333–0.832, p = 0.006).

Conclusion

This meta-analysis finds that IA allows a decrease in parietal abscesses and time to first gas and stools, surgical repair and length of stay, with similar overall complications.

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Authors and Affiliations

  1. Department of Digestive and Hepatobiliary Surgery Estaing Hospital, University Hospital of Clermont-Ferrand, 1, place Lucie-et-Raymond-Aubrac, 63003, Clermont-Ferrand, Cedex, France

    Marie Selvy, C. Mattevi, K. Slim & D. Pezet

  2. Clinical Research and Innovation Department, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France

    B. Pereira

  3. Department of Digestive Surgery, University Hospital of Saint-Etienne, Saint-Priest-en-Jarez, France

    B. Le Roy

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  1. Marie Selvy
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  2. C. Mattevi
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Correspondence to Marie Selvy.

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Selvy, M., Mattevi, C., Slim, K. et al. Intra-versus extracorporeal anastomosis in laparoscopic right colectomy: a meta-analysis of 3699 patients. Int J Colorectal Dis 35, 1673–1680 (2020). https://doi.org/10.1007/s00384-020-03675-y

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