Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study
Objectives: To describe detailed surgical techniques for totally stapled intracorporeal anastomosis (TSIA) and determine their feasibility and safety by comparing short-term outcomes with those of conventional totally stapled extracorporeal anastomosis (TSEA). Methods: In total, 59 consecutive patie...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-010/_pdf/-char/en |
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| author | Yoshiaki Fujii Kenji Kobayashi Hirozumi Sawai Seiya Yamamoto Shuhei Uehara Hirotaka Miyai Hiroki Takahashi Shuji Takiguchi |
| author_facet | Yoshiaki Fujii Kenji Kobayashi Hirozumi Sawai Seiya Yamamoto Shuhei Uehara Hirotaka Miyai Hiroki Takahashi Shuji Takiguchi |
| author_sort | Yoshiaki Fujii |
| collection | DOAJ |
| description | Objectives: To describe detailed surgical techniques for totally stapled intracorporeal anastomosis (TSIA) and determine their feasibility and safety by comparing short-term outcomes with those of conventional totally stapled extracorporeal anastomosis (TSEA).
Methods: In total, 59 consecutive patients who underwent laparoscopic colectomy between June 2018 and August 2021 were retrospectively assessed. Linear staplers were used for all anastomoses. The TSIA and TSEA groups included 23 and 36 patients, respectively. Following a comprehensive description of each surgical technique, propensity score matching analysis was conducted to compare matched groups on the basis of clinicopathological characteristics, surgical and perioperative outcomes, complications, and postoperative inflammatory reactions. After matching, 17 cases each were analyzed in the TSIA and TSEA groups.
Results: Both groups were well matched. The TSIA group had significantly lesser blood loss than did the TSEA group (10 versus 20 mL, p=0.002), although this result was not clinically significant. The skin excision length (4 versus 6 cm, p<0.001) and postoperative hospital stay length (6 versus 7 days, p<0.001) were significantly shorter in the TSIA group than in the TSEA group. Increasing C-reactive protein (CRP) values at 1, 3, and 6 postoperative days were significantly lower in the TSIA group than in the TSEA group (p=0.016, p=0.011, and p=0.012, respectively).
Conclusions: TSIA is a simple, feasible, and efficient surgical technique; compared with TSEA, it is less invasive and associated with lesser blood loss, shorter skin incision lengths, shorter postoperative hospital stays, and lower CRP level increases. |
| format | Article |
| id | doaj-art-c12f381312a940f8b896dfc3d2362532 |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-c12f381312a940f8b896dfc3d23625322025-01-27T10:02:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-01-01919510410.23922/jarc.2024-0102024-010Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort StudyYoshiaki Fujii0Kenji Kobayashi1Hirozumi Sawai2Seiya Yamamoto3Shuhei Uehara4Hirotaka Miyai5Hiroki Takahashi6Shuji Takiguchi7Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical SciencesDepartment of Surgery, Kariya Toyota General HospitalDepartment of Surgery, Narita Memorial HospitalDepartment of Gastroenterological Surgery, Nagoya City University Graduate School of Medical SciencesDepartment of Gastroenterological Surgery, Nagoya City University Graduate School of Medical SciencesDepartment of Surgery, Kariya Toyota General HospitalDepartment of Gastroenterological Surgery, Nagoya City University Graduate School of Medical SciencesDepartment of Gastroenterological Surgery, Nagoya City University Graduate School of Medical SciencesObjectives: To describe detailed surgical techniques for totally stapled intracorporeal anastomosis (TSIA) and determine their feasibility and safety by comparing short-term outcomes with those of conventional totally stapled extracorporeal anastomosis (TSEA). Methods: In total, 59 consecutive patients who underwent laparoscopic colectomy between June 2018 and August 2021 were retrospectively assessed. Linear staplers were used for all anastomoses. The TSIA and TSEA groups included 23 and 36 patients, respectively. Following a comprehensive description of each surgical technique, propensity score matching analysis was conducted to compare matched groups on the basis of clinicopathological characteristics, surgical and perioperative outcomes, complications, and postoperative inflammatory reactions. After matching, 17 cases each were analyzed in the TSIA and TSEA groups. Results: Both groups were well matched. The TSIA group had significantly lesser blood loss than did the TSEA group (10 versus 20 mL, p=0.002), although this result was not clinically significant. The skin excision length (4 versus 6 cm, p<0.001) and postoperative hospital stay length (6 versus 7 days, p<0.001) were significantly shorter in the TSIA group than in the TSEA group. Increasing C-reactive protein (CRP) values at 1, 3, and 6 postoperative days were significantly lower in the TSIA group than in the TSEA group (p=0.016, p=0.011, and p=0.012, respectively). Conclusions: TSIA is a simple, feasible, and efficient surgical technique; compared with TSEA, it is less invasive and associated with lesser blood loss, shorter skin incision lengths, shorter postoperative hospital stays, and lower CRP level increases.https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-010/_pdf/-char/enc-reactive proteindelta-shaped overlap anastomosisextracorporeal anastomosisintracorporeal anastomosislaparoscopic colectomy |
| spellingShingle | Yoshiaki Fujii Kenji Kobayashi Hirozumi Sawai Seiya Yamamoto Shuhei Uehara Hirotaka Miyai Hiroki Takahashi Shuji Takiguchi Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study Journal of the Anus, Rectum and Colon c-reactive protein delta-shaped overlap anastomosis extracorporeal anastomosis intracorporeal anastomosis laparoscopic colectomy |
| title | Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study |
| title_full | Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study |
| title_fullStr | Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study |
| title_full_unstemmed | Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study |
| title_short | Short-term Outcomes of Intracorporeal Versus Extracorporeal Totally Stapled Anastomosis after Laparoscopic Colectomy: A Propensity Score-matched Cohort Study |
| title_sort | short term outcomes of intracorporeal versus extracorporeal totally stapled anastomosis after laparoscopic colectomy a propensity score matched cohort study |
| topic | c-reactive protein delta-shaped overlap anastomosis extracorporeal anastomosis intracorporeal anastomosis laparoscopic colectomy |
| url | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-010/_pdf/-char/en |
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