Ann Surg Treat Res.  2024 Aug;107(2):59-67. 10.4174/astr.2024.107.2.59.

Intracorporeal anastomosis in minimally invasive right hemicolectomy: a nationwide survey of the Korean Society of Coloproctology

• Yang SS
• Kye BH
• Kang SH
• Kim CH
• Kim JH
• Kim WR
• Lee KY
• Park IK

• KMID: 2558382
• DOI: http://doi.org/10.4174/astr.2024.107.2.59

Abstract

Purpose
We investigated the current practices and perceptions of colorectal surgeons in South Korea regarding intracorporeal ileocolic anastomosis (IIA) in minimally invasive right hemicolectomy (RHC).
Methods
Members of the Korean Society of Coloproctology (KSCP) participated in an online survey encompassing demographic information, surgical experiences, methods for IIA, and advantages, barriers, and perceptions of IIA. We performed a statistical analysis of survey results.
Results
Among the 1,074 KSCP members contacted, 178 responded to the survey. Most respondents were males aged 40–49 years with >10 years of experience who were affiliated with a tertiary healthcare facility. One hundred fifty-six respondents had performed <100 colorectal cancer surgeries annually. Fifty-nine respondents reported experiences of the IIA technique in minimally invasive RHC. Most respondents favored the isoperistaltic side-to-side (S-S) anastomosis and stapled S-S anastomosis, hand-sewn closure for the common channel, and the periumbilical area for primary specimen extraction. Respondents with IIA experience emphasized the reduction in postoperative complications as the primary reason for performing IIA, whereas respondents without IIA experience cited the lack of benefits as the main deterrent. Respondents commonly cited concerns regarding anastomotic leakage and intraabdominal contamination as the primary reasons for not performing IIA. Respondents with IIA experience demonstrated a more positive response towards attempting or transitioning to IIA than those without. Respondents with IIA experience prioritized self-sufficiency, whereas respondents without IIA experience prioritized proctorship and discussions of the initial cases.
Conclusion
Measures to standardize the IIA technique and appropriate training programs must be implemented to enhance its use in minimally invasive RHC.

Keyword

Colon; Colectomy; Minimally invasive surgical procedure; Surgical anastomosis; Surveys and questionnaires

Figure

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  Fig. 1 Methods for intracorporeal ileocolic anastomosis (IIA) as reported by the survey respondents. (A) Frequency of IIA in respondents with IIA experience. (B) Configuration of IIA in respondents with IIA experience. (C) Technique of IIA in respondents with IIA experience. (D) Closure of the common channel in respondents with IIA experience. (E) Specimen extraction site in respondents with IIA experience.

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