Abstract
Purpose
To the best of our knowledge, no studies have compared the short-term outcomes between colo-colonic extracorporeal triangular anastomosis (TA) and functional end-to-end anastomosis (FEEA), with a focus on laparoscopic-assisted surgery for left-sided colon cancer. Therefore, this study compared the short-term outcomes of these anastomoses using propensity score matching analysis.
Methods
This retrospective study included 129 patients with stage I–IV left-sided colon cancer who underwent laparoscopic-assisted surgery with colo-colonic extracorporeal TA (n = 75) or FEEA (n = 54) between May 2009 and March 2021. After propensity score matching, 84 patients (TA, n = 42; FEEA, n = 42) were included in the analysis. The primary endpoint was the complication rate for all grades, and the secondary endpoints were the rates of Clavien − Dindo grade ≥ 3 complications and anastomotic leakage.
Results
In the matched cohort, there were no significant differences in the complication rates for all grades (35.7% vs. 26.2%, p = 0.479), Clavien − Dindo grade ≥ 3 complications (11.9% vs. 11.9%, p = 1), and anastomotic leakage (0% vs. 4.8%, p = 0.494) between the TA and FEEA groups. In the univariate logistic regression analysis, TA did not increase the frequency of complications for any grades compared with FEEA (odds ratio: 1.570, 95% confidence interval: 0.616–3.980, p = 0.347).
Conclusion
Extracorporeal TA demonstrated equivalent short-term outcomes compared with FEEA in cases of laparoscopic-assisted surgery for left-sided colon cancer. TA can be an alternative anastomosis technique in cases wherein FEEA is difficult to perform.
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The data that support the findings of this study are available on request from the corresponding author.
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KS, KI, HK, MK, MU, YT, DY, AS, KI, and KN contributed to the study concept and design. KS, KI, HK, MK, MU, YT, DY, AS, and KI performed the operations. HK and KN supervised the study. KS, KI, HK, MK, MU, YT, DY, AS, KI, and KN participated in the interpretation of the results and writing of the report. All authors read and approved the final manuscript.
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This study was approved by the Human Research Ethics Committee of Hakodate Municipal Hospital (Hakodate, Hokkaido, Japan; reference no. 2021–43).
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Sato, K., Imaizumi, K., Kasajima, H. et al. Short-term outcomes of extracorporeal colo-colonic triangular anastomosis versus functional end-to-end anastomosis in laparoscopic-assisted surgery for left-sided colon cancer: a propensity score matching analysis. Langenbecks Arch Surg 407, 747–757 (2022). https://doi.org/10.1007/s00423-021-02403-6
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DOI: https://doi.org/10.1007/s00423-021-02403-6