Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side? Zheng Liu1†, Guiyu Wang1†, Ming Yang2†, Yinggang Chen1, Dazhuang Miao1, Shan Muhammad1 and Xishan Wang1,3*
Abstract Background: The purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer. Methods: We enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed. Results: A total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications. Conclusion: An FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer. Keywords: anastomosis, colon cancer, right hemicolectomy
Background Performing anastomosis after colectomy is one of the basic skills of a general surgeon [1]. Bowel anastomosis is conventionally performed using a handsewn technique, which has been practiced successfully for over 100 years [2]. Because stapled anastomosis takes less time to perform and the learning curve for the inexperienced surgeon is short, mechanical stapling devices are widely used in gastrointestinal surgery [3-5]. There are several configurations of ileocolonic anastomosis, such as functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) [6]. The end-to-end anastomosis (EEA) is possible only using the handsewn technique. An ESA is commonly used in a right hemicolectomy. * Correspondence: [email protected] † Equal contributors 1 Department of Colorectal Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, 150081 Harbin, China 3 Colorectal Cancer Institute, Harbin Medical University, 246 Xuefu Road, 150081 Harbin, China Full list of author information is available at the end of the article
This anastomosis proceeds in a manner very similar to that of the EEA [7]. Because of the disparity in size between the ileum and colon, the anastomotic complications of ESA and EEA are not rare [8]. In an effort to decrease anastomotic complications, the stapled FEEA was developed [9]. The FEEA is a side-to-side anastomosis, and follows the excision of the ileocecal site and the ascending colon using linear stap
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