Our Summary

This research paper is about a study that looked at the likelihood of getting an incisional hernia (a type of hernia that occurs through a scar from a previous surgery) after a certain type of surgery for colon cancer. The surgery is called a laparoscopic right colectomy, and it can be done in two different ways: intracorporeal anastomotic reconstruction (ICA) or extracorporeal anastomotic reconstruction (ECA).

The team studied two groups of patients who had this surgery. One group, the prospective group, had the ICA method between January 2018 and February 2020. The other group, the retrospective group, had the ECA method between January 2013 and December 2016.

After the surgery, the researchers tracked the patients to see who got an incisional hernia. They did this by looking at the patients’ CT scans or talking to the patients on the phone or in person. They also looked at how long the patients stayed in the hospital, whether there were any complications after the surgery, whether they had to be re-admitted to the hospital within 30 days, whether they had to have another surgery, and if any of the patients died.

The study included 89 patients, 48 of whom had ECA and 41 had ICA. After following them for about 36 months, they found that only 1 patient (2.4%) in the ICA group got an incisional hernia, while 11 patients (22.9%) in the ECA group did. This means that patients who had the ICA method were less likely to get an incisional hernia. The length of the hospital stay and the rates of complications, readmissions, reoperations, and deaths were similar for both groups.

In simple terms, the study suggests that the ICA method for this type of surgery may be better than the ECA method because it seems to result in fewer hernias afterwards.

FAQs

  1. What is the difference between intracorporeal anastomotic reconstruction (ICA) and extracorporeal anastomotic reconstruction (ECA) in laparoscopic right colectomy?
  2. Does the type of anastomotic reconstruction procedure used in laparoscopic right colectomy affect the risk of incisional hernias?
  3. Were there any differences in postoperative complications, hospital stay, and recovery between patients who underwent ICA versus ECA in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laparoscopic colectomy is to consider opting for intracorporeal anastomotic reconstruction (ICA) over extracorporeal anastomotic reconstruction (ECA) in order to reduce the risk of developing incisional hernias after surgery. This study found that patients who underwent ICA had a significantly lower incidence of incisional hernias compared to those who underwent ECA. It is important to discuss the potential benefits and risks of different surgical techniques with your doctor to make an informed decision about your treatment.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with colon cancer, benign colon neoplasms, inflammatory bowel disease, diverticular disease, and other conditions that require surgical removal of a portion of the colon. These patients may benefit from the minimally invasive approach of laparoscopic surgery, which can lead to shorter hospital stays, faster recovery times, and reduced risk of complications compared to traditional open surgery. Additionally, patients who are deemed suitable candidates for laparoscopic colectomy are those who are generally healthy and have no contraindications for surgery.

Timeline

Before laparoscopic colectomy:

  • Patient undergoes preoperative evaluation and assessment
  • Patient may need to follow a preoperative diet or bowel preparation
  • Patient is admitted to the hospital on the day of surgery
  • Patient undergoes laparoscopic colectomy procedure

After laparoscopic colectomy:

  • Patient is monitored in the recovery room postoperatively
  • Patient may have a hospital stay of around 4-5 days
  • Patient is discharged home with postoperative instructions
  • Patient may experience postoperative pain, discomfort, and fatigue
  • Patient follows up with their healthcare provider for follow-up appointments and monitoring
  • Patient may need to gradually resume normal activities and diet
  • Patient may be at risk for incisional hernias, with long-term follow-up needed to monitor for complications.

What to Ask Your Doctor

  1. What is the difference between intracorporeal anastomotic reconstruction (ICA) and extracorporeal anastomotic reconstruction (ECA) in laparoscopic colectomy?
  2. What are the potential risks and benefits of each reconstruction technique?
  3. What is the incidence of incisional hernias following laparoscopic colectomy with ICA versus ECA?
  4. How will the presence of an incisional hernia affect my recovery and long-term outcomes?
  5. What is the typical length of hospital stay following laparoscopic colectomy with ICA or ECA?
  6. What are the common postoperative complications associated with laparoscopic colectomy?
  7. What is the likelihood of needing a reoperation within 30 days after laparoscopic colectomy with ICA or ECA?
  8. What follow-up care or monitoring will be necessary after the surgery to check for incisional hernias or other complications?
  9. Are there any specific lifestyle changes or precautions I should take to reduce the risk of developing an incisional hernia after laparoscopic colectomy?
  10. How does the reduced risk of incisional hernias with ICA compared to ECA impact my overall recovery and long-term outcomes after laparoscopic colectomy?

Reference

Authors: Pesce A, Petrarulo F, Fabbri N, Portinari M, Feo CV. Journal: J Laparoendosc Adv Surg Tech A. 2024 Feb;34(2):113-119. doi: 10.1089/lap.2023.0453. Epub 2023 Nov 29. PMID: 38226949