Single-layer versus double-layer closure of the enterotomy in laparoscopic right hemicolectomy with intracorporeal anastomosis: a single-center study

• DOI: 10.1007/s10151-015-1378-2
• Publication Date: 2015-10-15T15:52:18Z
• Authors: S. Reggio; A. Sciuto; D. Cuccurullo; F. Pirozzi; F. Esposito; D. Cusano; F. Corcione
• Keywords: Adult; Male; Anastomosis; Colon; Operative Time; Intracorporeal anastomosis; Anastomotic Leak; 03 medical and health sciences; Right colon cancer; 0302 clinical medicine; Ileum; Double layer; Surgical; 80 and over; Anastomotic leakage; Humans; Anastomotic leakage; Double layer; Intracorporeal anastomosis; Laparoscopic right colectomy; Right colon cancer; Adult; Aged; Aged, 80 and over; Anastomosis, Surgical; Anastomotic Leak; Colectomy; Colon; Female; Humans; Ileum; Laparoscopy; Length of Stay; Male; Middle Aged; Operative Time; Retrospective Studies; Suture Techniques; Surgery; Gastroenterology; Colectomy; Aged; Retrospective Studies; Aged, 80 and over; Anastomosis, Surgical; Suture Techniques; Gastroenterology; Length of Stay; Middle Aged; Laparoscopic right colectomy; 3. Good health; Surgery; Female; Laparoscopy

The aim of our study was to evaluate the short-term outcomes of totally laparoscopic right colectomy, in particular to compare the incidence of leakage of the ileocolic anastomosis after either single-layer (SL) or double-layer (DL) enterotomy closure.From March 2010 to July 2014, 162 patients underwent laparoscopic right colectomy with intracorporeal ileocolic anastomosis. The enterotomy was closed with either SL (77 patients) or DL technique (85 patients). Short-term outcomes in both groups were retrospectively analyzed.Median time to perform the ileocolic anastomosis was similar in the two groups (17 min in SL versus 20 min in DL, p = 0.109). DL closure was associated with a significantly lower incidence of anastomotic leakage (1.2 % in DL vs 7.8 % in SL, p = 0.044). Shorter hospital stay was also observed in the DL group.Adoption of DL closure of the enterotomy resulted in significantly improved outcome. We strongly recommend a double-layer closure technique when performing an intracorporeal enterocolic anastomosis.