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KMID : 1035920130160030045
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Journal of Minimally Invasive Surgery
2013 Volume.16 No. 3 p.45 ~ p.51
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Bowel Anastomosis in Single Port Laparoscopic Right Hemicolectomy: Comparison of Functional End to End Anastomosis and Isoperistaltic Side to Side Anastomosis
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Chung Seung-Woo
Yun Jung-A
Park Yoon-Ah
Huh Jung-Wook
Cho Yong-Beom
Kim Hee-Cheol
Lee Woo-Yong
Yun Seong-Hyeon
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Abstract
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Purpose: Colorectal surgeries by single port laparoscopic sur-gery (SPLS) are increasing. While recent studies have reported results that are similar with the idea of conventional laparo-scopy, SPLS is considered superior to conventional laparoscopy with regard to cosmetic aspects. We investigated the question of whether length of incision and postoperative recovery are different depending on the method of anastomosis in patients who underwent SPLS right hemicolectomy (RHC).
Methods: Data on patients who underwent SPLS RHC from May 2011 to April 2012 at Samsung Medical Center were retro-spectively collected. Among 117 patients, 31 received func-tional end-to-end anastomosis (FEEA) while 86 received iso-peristaltic side-to-side anastomosis (ISSA).
Results: Operation time was shorter in FEEA compared to ISSA (152±42 vs 172±35 min, p=0.01). Neither group re-quired an additional port. Although wound extension for speci-men delivery tended to be frequent in loop type specimen after FEEA, the result was statistically insignificant (58.1 vs 43.0%, p=0.15). No difference in wound length was observed (4.4±1.0 vs 4.5±1.5 cm). Length of stay was longer in ISSA compared to FEEA (6.3±2.1 vs 7.9±4.3 days, p=0.01), and there was no difference in first gas passage (2.5±0.9 vs 2.8±0.9 days, p=0.26). Although three patients (9.7%) with FEEA and 19 patients (22.1%) with ISSA had postoperative complications, the difference was insignificant.
Conclusion: Theoretically, delivery of a tube shaped speci-men after ISSA is expected to reduce unnecessary wound ex-tension and possible tumor dissemination compared to loop shape specimen after FEEA. However, results of our study showed no advantage in recovery period and wound length. We suggest that future prospective study might reveal more valuable conclusions on the subject.
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KEYWORD
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Single port laparoscopic surgery, Right hemi-colectomy, Bowel anastomosis, Functional end to end anastomosis, Isoperistaltic side to side anastomosis
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