Intracorporeal Anastomosis Reduces Surgical Stress Response in Laparoscopic Right Hemicolectomy: A Prospective Randomized Trial

Surg Laparosc Endosc Percutan Tech. 2018 Apr;28(2):77-81. doi: 10.1097/SLE.0000000000000506.

Abstract

Total laparoscopic right hemicolectomy is a procedure that involves an intracorporeal anastomosis. This approach may reduce tissue injury resulting in a significant lower surgical stress response (SSR) compared with the same procedure performed with an extracorporeal anastomosis. The purpose of this study was to compare the SSR level between 2 groups of patients undergoing laparoscopic right hemicolectomy with intracorporeal or extracorporeal anastomosis. From June 2015 to December 2016, 60 patients were enrolled and randomized. Interleukin-6, C-reactive protein, procalcitonin, white blood cell count, cortisol, prolactin, prealbumin, albumin, triglycerides, and transferrin were analyzed preoperatively and at 1, 3, and 5 days postoperatively. Interleukin-6 and C-reactive protein levels were significantly lower in the intracorporeal group on days 1, 3, and 5 postoperatively compared with the extracorporeal group. Gastrointestinal recovery was significantly earlier in the intracorporeal group. The intracorporeal anastomosis in laparoscopic right hemicolectomy reduces SSR, which may play a role in bowel recovery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / methods
  • C-Reactive Protein / metabolism
  • Colectomy / adverse effects*
  • Colon / physiopathology
  • Colon / surgery*
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Ileum / physiopathology
  • Ileum / surgery*
  • Interleukin-6 / blood
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Period
  • Prognosis
  • Prospective Studies
  • Recovery of Function*
  • Stress, Physiological / physiology*
  • Treatment Outcome
  • Young Adult

Substances

  • Interleukin-6
  • C-Reactive Protein