title: Extracorporeal versus intracorporeal anastomosis after laparoscopic right colectomy for cancer: a case-control study.
abstract: BACKGROUND
  The purpose of this study was to compare the short-term outcome (3 months) of laparoscopic right colectomy, between intra- and extracorporeal anastomosis techniques.
  
  
  METHODS
  This study was designed as a case-controlled study from a prospective colorectal cancer database. Forty consecutive patients who underwent laparoscopic right hemicolectomy with intracorporeal anastomosis (totally laparoscopic colectomy, TLC) for adenocarcinoma, with the exception of T4 lesions and metastasis, were compared with 40 patients who underwent laparoscopic right hemicolectomy with extracorporeal anastomosis (laparoscopic-assisted colectomy, LAC). Controls were matched for stage, age, and gender via a statistically generated selection of all laparoscopic right hemicolectomies performed between October 2006 and August 2009.
  
  
  RESULTS
  In terms of operating time (median 150 min), histopathological results, surgical site complications (5% for LAC and 2.5% for TLC), nonsurgical site complications (2.5% for LAC and 5% for TLC), hospitalization (median 5 days), there were no differences between the groups (p > 0.05). Incision length was significantly shorter for TLC (p < 0.05), but no differences were observed for postoperative use of analgesics. There were six postoperative cases of vomiting with reinsertion of nasogastric tube in the LAC group and only one case in the TLC group (p < 0.05).
  
  
  CONCLUSIONS
  TLC seems feasible and safe, it does not significantly affect the length of surgery, and it guarantees maintenance of radical oncological standards. Furthermore, it significantly improves cosmesis and patient comfort postoperatively, reducing the rates of emesis, which leads to higher rates of early regular diet tolerance.
authors: Department of General Surgery, Misericordia and Dolce Hospital, Piazza dell'Ospedale 5, 59100, Prato (Po), Italy.
authors: Marco
authors: M
authors: Scatizzi
authors: Katrin C
authors: KC
authors: Kröning
authors: Andrea
authors: A
authors: Borrelli
authors: Gordon
authors: G
authors: Andan
authors: Elisa
authors: E
authors: Lenzi
authors: Francesco
authors: F
authors: Feroci
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged