International Journal of Colorectal Disease

, Volume 33, Issue 3, pp 291–298 | Cite as

Does laparoscopic intracorporeal ileocolic anastomosis decreases surgical site infection rate? A propensity score-matched cohort study

  • L. Martinek
  • K. You
  • S. Giuratrabocchetta
  • M. Gachabayov
  • K. Lee
  • R. Bergamaschi
Original Article
  • 96 Downloads

Abstract

Aim

Foreshortened mesentery or thick abdominal wall constitutes a rationale for laparoscopic intracorporeal ileocolic anastomoses (ICA). The aim of this study was to compare intracorporeal to extracorporeal ICA in terms of surgical site infections in patients with Crohn’s ileitis and overweight patients with right colon tumors.

Method

This was a prospective propensity score-matched cohort study enrolling consecutive patients with Crohn’s terminal ileitis and overweight patients with right colon tumors undergoing elective laparoscopic right colon resection with intracorporeal or extracorporeal ICA. Propensity score matching with a 1:1 ratio was employed to compare diagnosis-matched patients for age, BMI, ASA, and previous abdominal surgery.

Results

Overall, 453 patients were enrolled: 233 intracorporeal vs. 220 extracorporeal. Propensity score matching left 195 intracorporeal and 195 extracorporeal patients comparable for age (p = 0.294), gender (p = 0.683), ASA (p = 0.545), BMI (p = 0.079), previous abdominal surgery (p = 0.348), and diagnosis (p = 0.301). Conversion rates (5.1 vs. 3.6%; p = 0.457) and intraoperative complications (1 vs. 2.1%; p = 0.45) were similar. Overall morbidity (5.1 vs. 12.8%; p = 0.008) and re-intervention rates (3.1 vs. 8.7%; p = 0.029) were significantly higher in extracorporeal patients. Anastomotic leak rates (0.5 vs. 1.5%; p = 0.623) did not differ. Incisional SSI rate was significantly higher in extracorporeal patients (p = 0.01).

Conclusion

Laparoscopic intracorporeal ICA reduced incisional SSI rates as compared to its extracorporeal counterpart.

Keywords

Laparoscopic right colectomy Ileocolic anastomosis Intracorporeal anastomosis Extracorporeal anastomosis Surgical site infection 

Notes

Acknowledgements

The authors extend their thanks to Lala Orujova for the drawing.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryUniversity Hospital OstravaOstravaCzech Republic
  2. 2.Division of Colorectal surgeryState University of New YorkStony BrookUSA

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