Our Summary

In a study of minimally invasive colectomy, a surgery to remove part or all of the colon, researchers compared two methods of rejoining the bowel after part of it has been removed. These methods are called intracorporeal (IC) and extracorporeal (EC) anastomosis. The goal of the study was to see which method led to better results in terms of complications after surgery, operation time, blood loss, hospital stay length, necessity to switch to open surgery, and time for the bowel to start working again.

The study looked at 25 other studies involving 4450 patients in total. About half of the patients had IC anastomosis and the other half had EC anastomosis. The researchers found that IC anastomosis led to smaller incision sites, quicker bowel recovery, fewer complications, and less need to switch to open surgery. It also resulted in lower rates of leakage at the join site, surgical site infection, and hernia at the incision site compared to EC anastomosis. Therefore, IC anastomosis seems to be a better method than EC anastomosis for minimally invasive right colectomy.

FAQs

  1. What is the difference between intracorporeal (IC) and extracorporeal (EC) anastomosis in colectomy?
  2. What were the key findings of the study comparing IC and EC anastomosis?
  3. Why is IC anastomosis considered a better method than EC anastomosis for minimally invasive right colectomy?

Doctor’s Tip

A doctor might tell a patient that minimally invasive colectomy with intracorporeal anastomosis has been shown to have better outcomes in terms of quicker recovery, fewer complications, and lower rates of leakage and infection compared to extracorporeal anastomosis. It is important to discuss this option with your surgeon to determine the best approach for your individual case.

Suitable For

Patients who may be recommended for a colectomy include those with:

  • Colon cancer
  • Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  • Diverticulitis
  • Colonic polyps
  • Familial adenomatous polyposis
  • Chronic constipation or bowel obstruction
  • Colonic volvulus
  • Colonic ischemia
  • Colonic perforation

Ultimately, the decision to recommend a colectomy will depend on the specific condition and individual circumstances of the patient.

Timeline

Before colectomy:

  • Patient is diagnosed with a condition that requires removal of part or all of the colon
  • Patient undergoes pre-operative testing and consultations with their healthcare team
  • Patient may undergo bowel preparation to empty the colon before surgery
  • Patient is admitted to the hospital on the day of surgery

After colectomy:

  • Patient undergoes minimally invasive colectomy surgery, with either IC or EC anastomosis
  • In the immediate post-operative period, patient is monitored in the recovery room for any complications
  • Patient is gradually transitioned from a liquid to solid diet as bowel function returns
  • Patient may experience pain, fatigue, and changes in bowel habits as they recover
  • Patient is discharged from the hospital once they are able to eat, move around, and manage their pain
  • Patient follows up with their healthcare team for monitoring and management of any complications or concerns

Overall, the timeline for a patient before and after colectomy involves thorough preparation, surgery, recovery, and follow-up care to ensure a successful outcome.

What to Ask Your Doctor

  1. What is the reason for recommending a colectomy?
  2. How will the surgery be performed - laparoscopic, robotic, or open surgery?
  3. What are the potential risks and complications associated with colectomy?
  4. Is IC anastomosis or EC anastomosis the preferred method for my surgery?
  5. How long will the operation take and how much blood loss can be expected?
  6. How long will I need to stay in the hospital after the surgery?
  7. What is the expected recovery time and when can I resume normal activities?
  8. Will I need a temporary colostomy or ileostomy after the surgery?
  9. What type of pain management will be provided after the surgery?
  10. What dietary changes or restrictions will I need to follow post-surgery?

Reference

Authors: Emile SH, Elfeki H, Shalaby M, Sakr A, Bassuni M, Christensen P, Wexner SD. Journal: Tech Coloproctol. 2019 Nov;23(11):1023-1035. doi: 10.1007/s10151-019-02079-7. Epub 2019 Oct 23. PMID: 31646396