Laparoscopic right hemicolectomy: intracorporeal and extracorporeal anastomosis
https://doi.org/10.24884/0042-4625-2025-184-4-94-101
Abstract
Introduction. The laparoscopic approach is the gold standard in colorectal cancer surgery. The formation of an anastomosis during laparoscopic right hemicolectomy is possible both extracorporeal and intracorporeal. However, the need for advanced intracorporeal suturing skills and concerns about the safety of intracorporeal anastomosis have limited its use in practice. Contradictory study results highlight the need for further research.
The objective of this study was to review the available literature and analyze the published studies for both intracorporeal anastomosis and extracorporeal anastomosis, focusing on surgical efficacy and safety.
Materials and Methods. Randomized trials were searched in electronic databases in PubMed, eLIBRARY, the Cochrane Library, and Google Scholar using predefined keywords. During the search and study of materials, 8 randomized controlled trials and 6 meta-analyses were included in the final review and analysis.
Results. An initial database search revealed a total of 1,502 papers. After removing duplicates and reviewing texts, eight randomized controlled trials and six systematic reviews and meta-analyses were analyzed. Surgery duration and treatment costs were comparable between intracorporeal and extracorporeal anastomosis groups. Intracorporeal anastomosis was linked to reduced surgical stress, shorter incision length, faster gastrointestinal recovery, and shorter hospital stays, without increased intra-abdominal complications. Extracorporeal anastomosis showed higher rates of wound infections, moderate intestinal paresis, and postoperative ventral hernias.
Conclusion. Intracorporeal anastomosis may be a viable alternative to extracorporeal anastomosis in laparoscopic right hemicolectomy. However, the limited number of studies leaves questions about their comparative advantages unresolved.
About the Authors
A. V. Sazhin
Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka»
Russian Federation
Competing Interests:
Russian Federation
Sazhin Alexander V., Dr. of Sci. (Med.), Professor, Corresponding Member of the RAS, Director of the Institute of Surgery, Head of the Department of Faculty Surgery № 1 of the Institute of Surgery; Surgeon, Oncologist
1, Ostrovitianova str., Moscow, 117513
8, build. 3, Sosenskii Stan str., Moscow, 142770
Competing Interests:
The authors declare no conflict of interest.
I. V. Ermakov
Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka»
Russian Federation
Competing Interests:
Russian Federation
Ermakov Igor V., Cand. of Sci. (Med.), Associate Professor of the Department of Faculty Surgery № 1 of the Institute of Surgery, Senior Research Fellow of the Department of Abdominal Oncology of the Institute of Surgery; Surgeon, Oncologist
1, Ostrovitianova str., Moscow, 117513
8, build. 3, Sosenskii Stan str., Moscow, 142770
Competing Interests:
The authors declare no conflict of interest.
G. B. Ivakhov
Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka»
Russian Federation
Competing Interests:
Russian Federation
Ivakhov Georgy B., Dr. of Sci. (Med.), Professor of the Department of Faculty Surgery № 1 of the Institute of Surgery, Deputy Director of the Institute of Surgery, Head of the Department of Abdominal Oncology of the Institute of Surgery; Surgeon, Oncologist
1, Ostrovitianova str., Moscow, 117513
8, build. 3, Sosenskii Stan str., Moscow, 142770
Competing Interests:
The authors declare no conflict of interest.
N. A. Timoshenko
Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka»
Russian Federation
Competing Interests:
Russian Federation
Timoshenko Nikita A., Postgraduate Student of the Department of Faculty Surgery № 1 of the Institute of Surgery
1, Ostrovitianova str., Moscow, 117513
8, build. 3, Sosenskii Stan str., Moscow, 142770
Competing Interests:
The authors declare no conflict of interest.
I. S. Shikhin
Pirogov Russian National Research Medical University; Moscow Multidisciplinary Clinical Center «Kommunarka»
Competing Interests:
Shikhin Ivan S., Junior Research Fellow of the Department of Abdominal Oncology of the Institute of Surgery, Associate Professor at the Department of Faculty Surgery № 1 of the Institute of Surgery; Surgeon
1, Ostrovitianova str., Moscow, 117513
8, build. 3, Sosenskii Stan str., Moscow, 142770
Competing Interests:
The authors declare no conflict of interest.
I. A. Morozov
Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Morozov Ilya A., Resident of the Department of Faculty Surgery № 1 of the Institute of Surgery
1, Ostrovitianova str., Moscow, 117513
Competing Interests:
The authors declare no conflict of interest.
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For citations:
Sazhin A.V., Ermakov I.V., Ivakhov G.B., Timoshenko N.A., Shikhin I.S., Morozov I.A. Laparoscopic right hemicolectomy: intracorporeal and extracorporeal anastomosis. Grekov's Bulletin of Surgery. 2025;184(4):94-101. (In Russ.) https://doi.org/10.24884/0042-4625-2025-184-4-94-101
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