Intracorporeal Versus Extracorporeal Anastomosis in Robotic Right Colectomy A Multicenter, Triple-blind, Randomized Clinical Trial

Niclas Dohrn*, Helin Yikilmaz, Magnus Laursen, Faisal Khesrawi, Frederik Bjerg Clausen, Frederik Sørensen, Henrik Loft Jakobsen, Steffen Brisling, Jakob Lykke, Jens Ravn Eriksen, Mads Falk Klein, Ismail Gögenur

*Corresponding author af dette arbejde
15 Citationer (Scopus)

Abstract

Objective: To determine if minimally invasive right colectomy with intracorporeal anastomosis improves postoperative recovery compared to extra-corporeal anastomosis. Background: Previous trials have shown that intracorporeal anastomosis improves postoperative recovery; however, it has not yet been evaluated in a setting with optimized perioperative care or with patient-related outcome measures. Methods: This was a multicenter, triple-blind, randomized clinical trial at two high-volume colorectal centers with strict adherence to optimized perioperative care pathways. The patients underwent robotic right colectomy with either intracorporeal or extracorporeal anastomosis. The primary outcome was patient-reported postoperative recovery measured using the “Quality of Recovery–15” questionnaire. ClinicalTrials.gov NCT03130166. Results: A total of 89 patients were randomized and analyzed according to the “Intention-to-treat”-principle. We found no statistically significant differences in patient-reported recovery between the groups. Postoperative pain, nausea, time to ambulation, time to first passage of flatus/ stool, length of hospital stay, and pathophysiological tests showed no differences either. The duration of time to create the anastomosis was significantly longer with intracorporeal anastomosis (17 vs 13 min, P = 0.003), while all other intraoperative, postoperative, and pathology variables showed no difference. Conclusion: There were no significant differences in postoperative recovery between the two groups.

OriginalsprogEngelsk
TidsskriftAnnals of Surgery
Vol/bind276
Udgave nummer5
Sider (fra-til)E294-E301
ISSN0003-4932
DOI
StatusUdgivet - 1 nov. 2022

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