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Purpose <p>The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.</p> Methods <p>This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.</p> Results <p>In the IA group, the DM was significantly longer (117.9 ± 49.5&#xa0;mm vs. 78.2 ± 30.1&#xa0;mm, <i>p</i> &lt; 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, <i>p</i> = 0.031). A multivariate analysis identified IA as an independent factor for DM &gt; 10&#xa0;cm (odds ratio [OR] = 0.25, <i>p</i> = 0.001) and &gt; 12 dissected lymph nodes (OR = 0.15, <i>p</i> = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.</p> Conclusions <p>IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.</p>

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Oncological merits of intracorporeal anastomosis versus extracorporeal anastomosis for right-sided colon cancer

  • 期刊论文

  • 发表日期：

    2025年5月24日

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  • Katsuya Watanabe,
  • Taro Oshikiri,
  • Kyosuke Habu,
  • Yusuke Ogi,
  • Hiroki Sugishita,
  • Satoshi Akita,
  • Motohira Yoshida,
  • Shigehiro Koga,
  • Kei Ishimaru,
  • Yuji Watanabe

摘要

Purpose

The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.

Methods

This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.

Results

In the IA group, the DM was significantly longer (117.9 ± 49.5 mm vs. 78.2 ± 30.1 mm, p < 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, p = 0.031). A multivariate analysis identified IA as an independent factor for DM > 10 cm (odds ratio [OR] = 0.25, p = 0.001) and > 12 dissected lymph nodes (OR = 0.15, p = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.

Conclusions

IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.