Risk of ileocolic anastomosis failure after right hemicolectomy for cancer. A comparison between different techniques.

Background: In recent years, the role of laparoscopic approach in the surgical treatment of right colon cancer has increased. Results comparing the different techniques of ileocolic anastomoses are controversial, with studies only reporting some advantages of the intracorporeal laparoscopic technique. The aim of this study is to compare the outcomes between laparoscopic versus open hemicolectomy for right colon cancer, focusing on anastomotic techniques (intracorporeal vs extracorporeal in the laparoscopic procedure, and manual vs mechanical in the laparotomic procedure).

Methods: This is a retrospective single center study enrolling patients with right colon cancer from January 2016 to December 2020. Primary endpoint of the study was the rate of anastomotic leak (AL).

Results: A total of 161 patients who underwent right hemicolectomy were enrolled: 91 were performed with laparoscopic technique, and 70 with open technique. Overall, AL occurred in 15 pts (9.3%). We observed 4 AL in intracorporeal (12.9%) and 6 in extracorporeal (10%) anastomoses, respectively. In the laparotomy group 5 patients (7.1%) developed AL, of which 3 (5.7%) and 2 (11.1%) manually and mechanically performed, respectively.

Conclusions: Based on our findings, laparoscopic hemicolectomy has a higher incidence of anastomotic leak. In the laparoscopic group, we observed the lowest rate of AL with extracorporeal mechanical anastomosis. When performed extracorporeally with open technique, hand-sewn anastomosis has better results than mechanical.

Key Words: Anastomosis, Cancer, Ileotransverse, Leakage, Right Colectomy.