講演情報
[INTS2-2]New Developments in Minimally Invasive Surgery for Colon Cancer: Outcomes and Future Challenges of Intracorporeal Anastomosis
*Hiroyoshi Iwata1, Chikayoshi Tani1, Shinnosuke Sato1, Masahide Otani1, Mizuho Ohara1, Tatsuya Shonaka1, Kimiharu Hasegawa1, Hideki Yokoo1 (1. Division of Gastroenterological and Transplant Surgery, Department of Surgery, Asahikawa Medical University, Japan)
Background: Intracorporeal anastomosis in laparoscopic colectomy has become increasingly adopted because it may reduce bowel mobilization, traction-related injury, incision length, postoperative pain, and promote earlier recovery of bowel function and oral intake. However, concerns remain regarding bacteriological and oncological safety, including intra-abdominal contamination due to intestinal spillage during anastomosis and possible peritoneal dissemination of tumor cells.
Objective: This study aimed to evaluate the initial safety and short-term outcomes of intracorporeal anastomosis for colon cancer surgery.
Methods: We retrospectively reviewed 34 patients who underwent colectomy with intracorporeal anastomosis for colon cancer at our institution. Patient characteristics, tumor factors, anastomotic procedures, operative outcomes, postoperative short-term outcomes, and recurrence were analyzed.
Results: The median age was 75 years, and the male-to-female ratio was 20:14. Tumors were located in the right colon in 23 patients and in the left colon in 11 patients, with pathological stages 0/I/II/III/IV in 2/8/13/8/4 patients, respectively. Functional end-to-end, delta-shaped, and overlap anastomoses were performed in 6/10/7 right-sided and 0/2/9 left-sided cases, respectively. The median operative time was 281 minutes, median blood loss was 0 mL, and median time to oral intake and postoperative hospital stay were 3 and 14 days, respectively. Although intraoperative intestinal spillage occurred in three patients, no intra-abdominal abscess or Clavien–Dindo grade III or higher complications were observed. Peritoneal recurrence occurred in one patient with pStage II disease.
Conclusion: Intracorporeal anastomosis may represent a new option in minimally invasive surgery for colon cancer. However, for its safe and widespread implementation, standardization of the surgical technique and further evaluation of long-term oncological outcomes are essential.
Objective: This study aimed to evaluate the initial safety and short-term outcomes of intracorporeal anastomosis for colon cancer surgery.
Methods: We retrospectively reviewed 34 patients who underwent colectomy with intracorporeal anastomosis for colon cancer at our institution. Patient characteristics, tumor factors, anastomotic procedures, operative outcomes, postoperative short-term outcomes, and recurrence were analyzed.
Results: The median age was 75 years, and the male-to-female ratio was 20:14. Tumors were located in the right colon in 23 patients and in the left colon in 11 patients, with pathological stages 0/I/II/III/IV in 2/8/13/8/4 patients, respectively. Functional end-to-end, delta-shaped, and overlap anastomoses were performed in 6/10/7 right-sided and 0/2/9 left-sided cases, respectively. The median operative time was 281 minutes, median blood loss was 0 mL, and median time to oral intake and postoperative hospital stay were 3 and 14 days, respectively. Although intraoperative intestinal spillage occurred in three patients, no intra-abdominal abscess or Clavien–Dindo grade III or higher complications were observed. Peritoneal recurrence occurred in one patient with pStage II disease.
Conclusion: Intracorporeal anastomosis may represent a new option in minimally invasive surgery for colon cancer. However, for its safe and widespread implementation, standardization of the surgical technique and further evaluation of long-term oncological outcomes are essential.