Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study)
Abstract Background Several randomized controlled trials and meta‐analyses have demonstrated the potential advantages of intracorporeal over extracorporeal anastomosis. However, the heterogeneity and small samples of these studies complicate drawing clear conclusions regarding such advantages. In th...
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2025-07-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.12915 |
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| author | Tomohiro Yamaguchi Keitaro Tanaka Jun Watanabe Hiroki Hamamoto Atsushi Nishimura Fumihiko Fujita Hirokazu Suwa Masaaki Ito Kazushige Kawai Junichiro Hiro Seiichiro Yamamoto Sho Nambara Masato Ota Yuri Ito Junji Okuda Masafumi Inomata Masahiko Watanabe Takeshi Naitoh ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery |
| author_facet | Tomohiro Yamaguchi Keitaro Tanaka Jun Watanabe Hiroki Hamamoto Atsushi Nishimura Fumihiko Fujita Hirokazu Suwa Masaaki Ito Kazushige Kawai Junichiro Hiro Seiichiro Yamamoto Sho Nambara Masato Ota Yuri Ito Junji Okuda Masafumi Inomata Masahiko Watanabe Takeshi Naitoh ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery |
| author_sort | Tomohiro Yamaguchi |
| collection | DOAJ |
| description | Abstract Background Several randomized controlled trials and meta‐analyses have demonstrated the potential advantages of intracorporeal over extracorporeal anastomosis. However, the heterogeneity and small samples of these studies complicate drawing clear conclusions regarding such advantages. In this nationwide, multicenter, retrospective cohort study, we aimed to clarify the benefits of intracorporeal over extracorporeal anastomosis in patients undergoing laparoscopic colectomy for colon cancer. Methods This study included 46 institutions. Patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy between January 2020 and December 2021 were evaluated. The effect of intracorporeal anastomosis on short‐term outcomes compared to extracorporeal anastomosis was assessed using propensity score matching. Results A total of 1245 patients (intracorporeal, n = 615; extracorporeal, n = 630) were included in the final analysis. The operative time was longer (228 vs. 207 min, p < 0.001), but blood loss was also lower (5.0 vs. 10.0 mL, p < 0.001) and the incidence of intraoperative vascular injury appeared lower (0.5% vs. 1.6%, p = 0.091) in the intracorporeal group than those in the extracorporeal group. The time to first passage of stool (2.9 vs. 3.5 days, p < 0.001) and length of hospital stay (9.3 vs. 10.2 days, p = 0.008) were shorter in the intracorporeal group. Conclusions Intracorporeal anastomosis showed advantages over extracorporeal anastomosis in terms of blood loss, intraoperative vascular injury (potentially), bowel recovery, and length of hospital stay, despite the longer operative time. |
| format | Article |
| id | doaj-art-b3fbac15eff84878b619fe4d53c31e0f |
| institution | Kabale University |
| issn | 2475-0328 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-b3fbac15eff84878b619fe4d53c31e0f2025-08-20T03:30:55ZengWileyAnnals of Gastroenterological Surgery2475-03282025-07-019473974910.1002/ags3.12915Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study)Tomohiro Yamaguchi0Keitaro Tanaka1Jun Watanabe2Hiroki Hamamoto3Atsushi Nishimura4Fumihiko Fujita5Hirokazu Suwa6Masaaki Ito7Kazushige Kawai8Junichiro Hiro9Seiichiro Yamamoto10Sho Nambara11Masato Ota12Yuri Ito13Junji Okuda14Masafumi Inomata15Masahiko Watanabe16Takeshi Naitoh17ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal SurgeryDepartment of Gastroenterological Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Surgery, Gastroenterological Center Yokohama City University Medical Center Yokohama Kanagawa JapanDepartment of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Surgery, Institute of Gastroenterology Nagaoka Chuo General Hospital Niigata JapanDepartment of Surgery Kurume University School of Medicine Fukuoka JapanDepartment of Surgery Yokosuka Kyosai Hospital Yokosuka JapanDepartment of Colorectal Surgery National Cancer Center Hospital East Chiba JapanDepartment of Colorectal Surgery Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo JapanDepartment of Surgery Fujita Health University Toyoake Aichi JapanDepartment of Gastroenterological Surgery Tokai University School of Medicine Isehara Kanagawa JapanDepartment of Gastroenterological Surgery Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo JapanDepartment of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of General and Gastroenterological Surgery Osaka Medical and Pharmaceutical University Takatsuki JapanDepartment of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Yufu JapanDepartment of Surgery Kitasato University Kitasato Institute Hospital Tokyo JapanDepartment of Lower Gastrointestinal Surgery Kitasato University School of Medicine Sagamihara JapanAbstract Background Several randomized controlled trials and meta‐analyses have demonstrated the potential advantages of intracorporeal over extracorporeal anastomosis. However, the heterogeneity and small samples of these studies complicate drawing clear conclusions regarding such advantages. In this nationwide, multicenter, retrospective cohort study, we aimed to clarify the benefits of intracorporeal over extracorporeal anastomosis in patients undergoing laparoscopic colectomy for colon cancer. Methods This study included 46 institutions. Patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy between January 2020 and December 2021 were evaluated. The effect of intracorporeal anastomosis on short‐term outcomes compared to extracorporeal anastomosis was assessed using propensity score matching. Results A total of 1245 patients (intracorporeal, n = 615; extracorporeal, n = 630) were included in the final analysis. The operative time was longer (228 vs. 207 min, p < 0.001), but blood loss was also lower (5.0 vs. 10.0 mL, p < 0.001) and the incidence of intraoperative vascular injury appeared lower (0.5% vs. 1.6%, p = 0.091) in the intracorporeal group than those in the extracorporeal group. The time to first passage of stool (2.9 vs. 3.5 days, p < 0.001) and length of hospital stay (9.3 vs. 10.2 days, p = 0.008) were shorter in the intracorporeal group. Conclusions Intracorporeal anastomosis showed advantages over extracorporeal anastomosis in terms of blood loss, intraoperative vascular injury (potentially), bowel recovery, and length of hospital stay, despite the longer operative time.https://doi.org/10.1002/ags3.12915colectomycolonic neoplasmslaparoscopysurgical anastomosistreatment outcomes |
| spellingShingle | Tomohiro Yamaguchi Keitaro Tanaka Jun Watanabe Hiroki Hamamoto Atsushi Nishimura Fumihiko Fujita Hirokazu Suwa Masaaki Ito Kazushige Kawai Junichiro Hiro Seiichiro Yamamoto Sho Nambara Masato Ota Yuri Ito Junji Okuda Masafumi Inomata Masahiko Watanabe Takeshi Naitoh ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) Annals of Gastroenterological Surgery colectomy colonic neoplasms laparoscopy surgical anastomosis treatment outcomes |
| title | Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) |
| title_full | Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) |
| title_fullStr | Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) |
| title_full_unstemmed | Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) |
| title_short | Short‐term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi‐institutional cohort study in Japan (ICAN study) |
| title_sort | short term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer a nationwide multi institutional cohort study in japan ican study |
| topic | colectomy colonic neoplasms laparoscopy surgical anastomosis treatment outcomes |
| url | https://doi.org/10.1002/ags3.12915 |
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