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Session: ePoster Monitor 7-Colon Cancer 11

eP575 - Four-stapled Intracorporeal Anastomosis Technique in Totally Laparoscopic Colectomy for Colon Cancer

Monday, June 3, 2024
8:33 AM – 8:38 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Yoshiro Itatani

    Assistant Professor
    Department of Gastrointestinal Surgery
    Kyoto University
    Kyoto, Kyoto, Japan

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: Laparoscopic colectomy for colon cancer is widely accepted and has become one of the standard procedures for colorectal cancer. The general procedure of laparoscopic colectomy involves mobilization and dissection laparoscopically, and specimen extraction followed by anastomosis through a small-incision open laparotomy. Totally laparoscopic colectomy with intracorporeal anastomosis (ICA) for colon cancer is technically challenging due to the contamination risk of bacteria and cancer cells in the abdominal cavity. In fact, several previous studies reported prolonged operative time for laparoscopic colectomy using the ICA procedure. Here we have established a simple technique of ICA for totally laparoscopic colectomy named four-stapled technique (4ST). The 4ST requires only four cartridges of the linear stapler, and does not require any advanced suture or knot-tying skill.Methods/Interventions: We introduced the 4ST ICA in 2018. A total of 229 consecutive colon cancer patients (70 ICA and 159 extracorporeal anastomosis [ECA]) were analyzed to compare short-term surgical outcomes. Propensity score matching (PSM) analysis (1:1) was performed to adjust for patient background such as body-mass index (BMI, < 25 or 25 kg/m2), clinical TNM factors and surgical procedures (right-sided or left-sided resection). ResultsResults/Outcomes: After PSM, 57 patients in the ICA group and 57 patients in the ECA group were compared. There were no group differences in the patient background (age, sex, BMI, performance status, preoperative CEA level, tumor size, TNM staging) after PSM. With regard to surgical outcomes, operative time was significantly shorter in the ICA group than the ECA group (195 vs. 234 min, respectively, P < 0.05). Other surgical and short-term outcomes such as numbers of harvested lymph nodes, length of proximal and distal margins, estimated blood loss, inflammation factors such white blood cell count and CRP value on postoperative day 1, and postoperative complications ( Clavien-Dindo grade II) were the same between groups.Conclusion/

Discussion: In conclusion, our 4ST ICA procedure shortened operative time, without affecting other surgical and short-term outcomes such as extent of the colon resection (harvested lymph nodes and proximal/distal margins) or postoperative complications.