Intracorporeal versus extracorporeal anastomosis for minimally invasive right colectomy: A multi-center propensity score-matched comparison of outcomes Article

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cited authors

  • Cleary, Robert K., Kassir, Andrew, Johnson, Craig S., Bastawrous, Amir L., Soliman, Mark K., Marx, Daryl S., Giordano, Luca, Reidy, Tobi J., Parra-Davila, Eduardo, Obias, Vincent J., Carmichael, Joseph C., Pollock, Darren, Pigazzi, Alessio

funding text

  • This study was sponsored and funded by Intuitive Surgical Inc., Sunnyvale, CA, USA, in association with the identified study investigators under a cooperative clinical trial agreement. By way of this standard agreement, the funders met with each site to ensure standardized data collection from each site. In addition, the funders presented the de-identified data collected by each site to a 3rd party statistician for statistical analysis. The authors had full ownership of the study execution, analysis and development of the manuscript. All authors in this study contributed significantly to development of the study idea, study design and methodology, interpretation of unadjusted and adjusted data, and writing and revision of all keys elements of the manuscript.

abstract

  • Background The primary objective of this study was to retrospectively compare short-term outcomes of intracorporeal versus extracorporeal anastomosis for minimally invasive laparoscopic and robotic-assisted right colectomies for benign and malignant disease. Recent studies suggest potential short-term outcomes advantages for the intracorporeal anastomosis technique. Methods This is a multicenter retrospective propensity score-matched comparison of intracorporeal and extracorporeal anastomosis techniques for laparoscopic and robotic-assisted right colectomy between January 11, 2010, and July 21, 2016. Results After propensity score-matching, there were a total of 1029 minimal invasive surgery cases for analysis-379 right colectomies (335 robotic-assisted and 44 laparoscopic) done with an intracorporeal anastomosis and 650 right colectomies (253 robotic-assisted and 397 laparoscopic) done with an extracorporeal anastomosis. There were no significant differences in any preoperative patient characteristics between groups. The minimally invasive intracorporeal anastomosis group had significantly longer operative times (p<0.0001), lower conversion to open rate (p = 0.01), shorter hospital length of stay (p = 0.02) and lower complication rate from after discharge to 30-days (p = 0.04) than the extracorporeal anastomosis group. Conclusions This comparison shows several clinical outcomes advantages for the intracorporeal anastomosis technique in minimally invasive right colectomy. These data may guide future refinements in minimally invasive training techniques and help surgeons choose among different minimally invasive options.

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Publication Date

  • October 24, 2018

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volume

  • 13

issue

  • 10

WoS Citations

  • 0

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  • 39