We have located links that may give you full text access.
COMPARATIVE STUDY
JOURNAL ARTICLE
SYSTEMATIC REVIEW
Side-to-Side Anastomosis In Left Hemicolectomy, Why and When: A Single-Center Experience.
Surgical Technology International 2019 May 16
BACKGROUND: Laparoscopic colectomy represents a safe, effective and well-established procedure for both benign and malignant colic disease. Transanal anastomosis (TA) with a circular stapler is the most commonly performed anastomotic technique in laparoscopic left hemicolectomy (LLH). We report our experience with side-to-side anastomosis (STSA) and side-to-end anastomosis (STEA) in selected patients with both emergency and elective LLH.
METHODS: A systematic review of the PubMed database was performed on recent studies that compared different anastomotic techniques after LLH. We collected internal data from June 2014 to July 2018 and compared our experience with the literature. The primary outcome was the anastomotic complication rate.
RESULTS: During the observation period, 158 patients underwent left hemicolectomy (LH). One-hundred-nineteen patients had malignant disease; 36 underwent surgery for complicated diverticular disease, one had a large strangulated incisional hernia, one had a sigmoid volvulus, and one had a sigmoid localization of endometriosis. Thirty open left hemicolectomies were performed. In 128 cases, a minimally invasive approach was used. Since conversion to open was necessary in 10 of these cases, 118 were totally LLH. STSA was performed in 64 cases; seven in an emergency setting and 57 in elective procedures. The overall anastomotic leak rate was 3.1% (2/64) and no anastomotic leak was reported in the emergency group (0/7). TA was performed in 15 cases, 93% in an elective setting (14/15), and the anastomotic leak rate was 13.3% (2/15). In 20 cases, we performed elective STEA and no anastomotic leak was recorded. In 19 cases, it was impossible to perform anastomosis and we decided to create a definitive colostomy.
CONCLUSION: Consistent with the literature data, our experience shows that, in selected cases, STSA and STEA are both safe and effective, with a lower anastomotic complication rate than TA.
METHODS: A systematic review of the PubMed database was performed on recent studies that compared different anastomotic techniques after LLH. We collected internal data from June 2014 to July 2018 and compared our experience with the literature. The primary outcome was the anastomotic complication rate.
RESULTS: During the observation period, 158 patients underwent left hemicolectomy (LH). One-hundred-nineteen patients had malignant disease; 36 underwent surgery for complicated diverticular disease, one had a large strangulated incisional hernia, one had a sigmoid volvulus, and one had a sigmoid localization of endometriosis. Thirty open left hemicolectomies were performed. In 128 cases, a minimally invasive approach was used. Since conversion to open was necessary in 10 of these cases, 118 were totally LLH. STSA was performed in 64 cases; seven in an emergency setting and 57 in elective procedures. The overall anastomotic leak rate was 3.1% (2/64) and no anastomotic leak was reported in the emergency group (0/7). TA was performed in 15 cases, 93% in an elective setting (14/15), and the anastomotic leak rate was 13.3% (2/15). In 20 cases, we performed elective STEA and no anastomotic leak was recorded. In 19 cases, it was impossible to perform anastomosis and we decided to create a definitive colostomy.
CONCLUSION: Consistent with the literature data, our experience shows that, in selected cases, STSA and STEA are both safe and effective, with a lower anastomotic complication rate than TA.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app