Comparison of the efficacy of isoperistaltic and antiperistaltic anastomosis in totally laparoscopic right hemicolectomy: a post-hoc analysis based on a national multicenter snapshot study
10.3760/cma.j.cn441530-20250321-00118
- VernacularTitle:完全腹腔镜下右半结肠切除术中顺蠕动和逆蠕动的疗效比较——基于一项全国多中心快照研究的事后分析
- Author:
Jie ZHOU
1
;
Jiale GAO
;
Hao ZHONG
;
Xiaodong GU
;
Minghui PANG
;
Hong ZHANG
;
Yugui LIAN
;
Lei ZHOU
;
Zhongtao ZHANG
;
Hongwei YAO
;
Zhenghao CAI
;
Bo FENG
Author Information
1. 上海交通大学医学院附属瑞金医院普通外科 上海市微创外科临床医学中心，上海 200025
- Publication Type:Journal Article
- Keywords:
Colon neoplasms;
Laparoscopic surgery;
Digestive tract reconstruction;
Isoperistaltic;
Antiperistaltic
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(11):1280-1284
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of two anastomosis methods on perioperative and pathological outcomes during totally laparoscopic right hemicolectomy (TLRH).Methods:In a national multicenter snapshot study, 1,854 patients who underwent laparoscopic right hemicolectomy were enrolled from 52 tertiary hospitals across China. The post-hoc analysis based on this study compared the data of 303 patients who underwent TLRH. Patients were divided into the antiperistaltic group (33 cases) and the isoperistaltic group (270 cases) according to type of anastomosis. Due to the significant difference in sample size between the two groups, propensity score matching (PSM) was performed to eliminate the influence of baseline characteristic discrepancies. The matching was based on the following known confounding factors: age, gender, body mass index (BMI), history of abdominal surgery, and history of diabetes, with a caliper value of 0.2. Perioperative and pathological outcomes were compared between the two groups.Results:After PSM, 33 patients were included in the antiperistaltic group and 65 patients in the isoperistaltic group. There were no statistically significant differences in baseline data between the two groups (all P>0.05). No significant differences were observed between the two groups in terms of operation time, blood loss, time to first defecation, time to first oral intake, or the incidence and grading of complications either (all P>0.05). However, length of postoperative hospital stay in the isoperistaltic group was significantly shorter than that in the antiperistaltic group, however (7.0 [6.0, 9.0] days vs. 8.0 [7.0, 10.5] days, P=0.049). In terms of pathological outcomes, there were also no statistically significant differences between the two groups in the number of harvested lymph nodes or the number of positive lymph nodes (all P>0.05). Conclusions:The two digestive tract reconstruction modalities, antiperistaltic and isoperistaltic anastomosis, have comparable perioperative safety and efficacy in TLRH. The isoperistaltic group had better outcomes in terms of postoperative hospital stay.
