Our Summary

This study compares the outcomes of two different surgical techniques used during a laparoscopic right hemicolectomy, a surgery to remove part of the colon, in patients with adenocarcinoma, a type of cancer. The two techniques are extracorporeal hand-sewn side-to-side isoperistaltic ileocolic anastomosis (EHSIA) and intracorporeal mechanic side-to-side isoperistaltic ileocolic anastomosis (IMSIA).

The researchers used data from 108 patients, half of whom underwent surgery with EHSIA and the other half with IMSIA. They found no significant differences between the two groups in terms of patient characteristics or type of surgery.

However, they did find that the IMSIA technique led to shorter surgery times and hospital stays. With IMSIA, surgeries took a median of 85 minutes, compared to 117.5 minutes with EHSIA. Patients who underwent surgery with IMSIA also had a shorter median hospital stay (5 days) compared to those who underwent surgery with EHSIA (6.5 days).

The study also found that more lymph nodes were harvested during surgery with EHSIA (17) than with IMSIA (12).

The researchers concluded that the IMSIA technique seems to offer benefits in terms of shorter surgery times and hospital stays. However, they noted that more studies are needed to definitively determine which technique is best.

FAQs

  1. What is the difference between EHSIA and IMSIA techniques used in laparoscopic right hemicolectomy?
  2. According to the study, how did the IMSIA technique affect surgery times and hospital stays compared to the EHSIA technique?
  3. What were the findings about lymph node harvesting in surgeries using EHSIA versus IMSIA techniques?

Doctor’s Tip

A doctor might tell a patient undergoing laparoscopic colectomy that the intracorporeal mechanic side-to-side isoperistaltic ileocolic anastomosis (IMSIA) technique may lead to shorter surgery times and hospital stays compared to the extracorporeal hand-sewn side-to-side isoperistaltic ileocolic anastomosis (EHSIA) technique. It is important to discuss with your surgeon which technique may be best for your individual case.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with adenocarcinoma, a type of cancer, in the colon. This study specifically looked at patients with adenocarcinoma undergoing a laparoscopic right hemicolectomy.

Timeline

Before laparoscopic colectomy, a patient typically undergoes preoperative evaluations, such as blood tests, imaging studies, and consultations with the surgical team. The patient may also need to follow a special diet and bowel preparation instructions to empty the colon before surgery.

During laparoscopic colectomy, the patient is placed under general anesthesia, and small incisions are made in the abdomen to insert a laparoscope and surgical instruments. The surgeon then removes the diseased portion of the colon and reconnects the healthy sections using either the EHSIA or IMSIA technique.

After laparoscopic colectomy, the patient is monitored in the recovery room before being transferred to a hospital room. The patient may experience some pain, bloating, and discomfort, which can be managed with medication. The patient will gradually resume eating and walking, and may be discharged from the hospital within a few days.

In the weeks following laparoscopic colectomy, the patient will have follow-up appointments with the surgical team to monitor their recovery and ensure that the surgical site is healing properly. The patient may also need to make dietary and lifestyle changes to aid in their recovery and prevent complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with laparoscopic colectomy?
  2. How do the EHSIA and IMSIA techniques differ in terms of surgical approach and outcomes?
  3. What factors should I consider when deciding between the EHSIA and IMSIA techniques for my surgery?
  4. How experienced are you in performing laparoscopic colectomies with both the EHSIA and IMSIA techniques?
  5. How will my recovery and post-operative care differ between the EHSIA and IMSIA techniques?
  6. Are there any long-term effects or considerations I should be aware of with either technique?
  7. What is the success rate for each technique in terms of cancer recurrence and overall recovery?
  8. Are there any specific dietary or lifestyle changes I should make before or after surgery with either technique?
  9. Will I need additional follow-up care or monitoring after surgery with either technique?
  10. Are there any ongoing research studies or advancements in laparoscopic colectomy techniques that I should be aware of?

Reference

Authors: Lepiane P, Balla A, Licardie E, Saraceno F, Alarcón I, Scaramuzzo R, Guida A, Morales-Conde S. Journal: JSLS. 2022 Jul-Sep;26(3):e2022.00039. doi: 10.4293/JSLS.2022.00039. PMID: 36071998