Estudio de casos y controles entre anastomosis intra y extracorpórea en pacientes intervenidos de hemicolectomía derecha laparoscópica

摘要

Introduction: There is still insufficient scientific evidence on which is the best technique toperform the anastomosis -intracorporeal (IC) or extracorporeal (EC)- in right laparoscopichemicolectomy. The objective of the present study is to determine whether there aredifferences to compare in both techniques.Material and methods: A study was performed on a prospective patient series subjected toright laparoscopic hemicolectomy in our Hospital. The preoperative and the postoperativevariables associated with complications recorded depending on the type of anastomosis.Results: A total of 60 patients were intervened form June 2004 to June 2010 (35 IC; 25 EC).There were no significant differences between both groups as regards baseline preoperativecharacteristics or associated comorbidities. The median operation time was 212 minutes(142-305 min), with no significant difference between both techniques. The number oflymph nodes removed was higher in the IC group (21 versus 14; p = 0.03). The beginningof oral tolerance and the first bowel movement were significantly earlier in the IC group. Thecomplications rate was similar for both groups (14% IC; 16% EC; p = 0.89). Three patients inthe IC group had anastomosis dehiscence. The mortality rate was 2.8% (one patient in eachgroup).Conclusion: Intracorporeal versus extracorporeal anastomosis in right laparoscopic hemicolectomycan obtain a higher number of resected lymph nodes and an earlier oral toleranceand intestinal transit.