Intracorporeal versus Extracorporeal Anastomosis in Robotic Right Colectomy: A Multicenter, Triple-Blind, Randomized Clinical Trial

Niclas Dohrn*, Helin Yikilmaz, Magnus Laursen, Faisal Khesrawi, Frederik Bjerg Clausen, Frederik Sørensen, Henrik Loft Jakobsen, Steffen Brisling, Jakob Lykke, Jens Ravn Eriksen, Mads Falk Klein, Ismail Gögenur

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review


OBJECTIVE: To determine if minimally invasive right colectomy with intracorporeal anastomosis improves postoperative recovery compared to extracorporeal anastomosis.

BACKGROUND: Previous trials have shown that intracorporeal anastomosis improves postoperative recovery; however, it has not yet been evaluated in a setting with optimized perioperative care or with patient-related outcome measures.

METHODS: This was a multicenter, triple-blind, randomized clinical trial at two high-volume colorectal centers with strict adherence to optimized perioperative care pathways. The patients underwent robotic right colectomy with either intracorporeal or extracorporeal anastomosis. The primary outcome was patient-reported postoperative recovery measured using the "Quality of Recovery-15" questionnaire (QoR-15). NCT03130166.

RESULTS: A total of 89 patients were randomized and analyzed according to the "Intention-to-treat"-principle. We found no statistically significant differences in patient-reported recovery between the groups. Postoperative pain, nausea, time to ambulation, time to first passage of flatus/stool, length of hospital stay, and pathophysiological tests showed no differences either. The duration of time to create the anastomosis was significantly longer with intracorporeal anastomosis (17 vs. 13 min, P = .003), while all other intraoperative, postoperative, and pathology variables showed no difference.

CONCLUSION: There were no significant differences in postoperative recovery between the two groups.

TidsskriftAnnals of Surgery
StatusUdgivet, E-publikation før trykning - 13 okt. 2021

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