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Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study

AIMS: The three main types of anastomotic configurations following colorectal resection are Side-to-Side Anastomosis (S-S), End-to-Side Anastomosis (E-S) and End-to-End Anastomosis (E-E). This study aims to present results from a local cohort supplemented by a systematic review with meta-analysis of...

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Autores principales: Lin, Snow Yunni, Buan, Bryan Jun Liang, Sim, Wilson, Jain, Sneha Rajiv, Chang, Heidi Sian Ying, Lee, Kuok Chung, Chong, Choon Seng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306133/
https://www.ncbi.nlm.nih.gov/pubmed/35046183
http://dx.doi.org/10.4103/jmas.jmas_161_21
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author Lin, Snow Yunni
Buan, Bryan Jun Liang
Sim, Wilson
Jain, Sneha Rajiv
Chang, Heidi Sian Ying
Lee, Kuok Chung
Chong, Choon Seng
author_facet Lin, Snow Yunni
Buan, Bryan Jun Liang
Sim, Wilson
Jain, Sneha Rajiv
Chang, Heidi Sian Ying
Lee, Kuok Chung
Chong, Choon Seng
author_sort Lin, Snow Yunni
collection PubMed
description AIMS: The three main types of anastomotic configurations following colorectal resection are Side-to-Side Anastomosis (S-S), End-to-Side Anastomosis (E-S) and End-to-End Anastomosis (E-E). This study aims to present results from a local cohort supplemented by a systematic review with meta-analysis of existing literature to compare the post-operative outcomes between E-S and S-S. METHODS: A cohort study of patients who underwent right colectomy with E-S or S-S anastomosis, was conducted at the National University Hospital Singapore. Electronic databases Embase and Medline were systematically searched from inception to 21 August 2020, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Studies were included if they compared post-operative outcomes between E-S and S-S. RESULTS: In the cohort study, 40 underwent E-S and 154 underwent S-S. Both post-operative ileus (12.5% vs. 29.2%, P = 0.041) and length of hospital stay (9.35 days vs. 14.04 days, P = 0.024) favoured E-S, but anastomotic bleed favoured S-S (15.0% vs. 3.2%, P = 0.004). Five studies were included in the meta-analysis with 860 E-S and 1126 S-S patients. Similarly, post-operative ileus (odds ratio [OR] =0.302; 95% confidence interval [CI]: 0.122–0.747; P = 0.010) and length of hospital stay (mean differences = ‒1.54 days; CI: ‒3.00 to ‒0.076 days; P = 0.039) favoured E-S. Additional sensitivity analysis including only stapled anastomosis showed a lower rate of anastomotic leak in E-S patients (OR = 0.185; 95% CI: 0.054–0.627; P = 0.007). CONCLUSIONS: This is the first systematic review to show that the E-S technique produces superior post-operative outcomes after right colectomy compared to S-S. However, the choice of anastomosis was largely surgeon dependent, but surgeon factors were not reported.
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spelling pubmed-93061332022-07-23 Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study Lin, Snow Yunni Buan, Bryan Jun Liang Sim, Wilson Jain, Sneha Rajiv Chang, Heidi Sian Ying Lee, Kuok Chung Chong, Choon Seng J Minim Access Surg Original Article AIMS: The three main types of anastomotic configurations following colorectal resection are Side-to-Side Anastomosis (S-S), End-to-Side Anastomosis (E-S) and End-to-End Anastomosis (E-E). This study aims to present results from a local cohort supplemented by a systematic review with meta-analysis of existing literature to compare the post-operative outcomes between E-S and S-S. METHODS: A cohort study of patients who underwent right colectomy with E-S or S-S anastomosis, was conducted at the National University Hospital Singapore. Electronic databases Embase and Medline were systematically searched from inception to 21 August 2020, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Studies were included if they compared post-operative outcomes between E-S and S-S. RESULTS: In the cohort study, 40 underwent E-S and 154 underwent S-S. Both post-operative ileus (12.5% vs. 29.2%, P = 0.041) and length of hospital stay (9.35 days vs. 14.04 days, P = 0.024) favoured E-S, but anastomotic bleed favoured S-S (15.0% vs. 3.2%, P = 0.004). Five studies were included in the meta-analysis with 860 E-S and 1126 S-S patients. Similarly, post-operative ileus (odds ratio [OR] =0.302; 95% confidence interval [CI]: 0.122–0.747; P = 0.010) and length of hospital stay (mean differences = ‒1.54 days; CI: ‒3.00 to ‒0.076 days; P = 0.039) favoured E-S. Additional sensitivity analysis including only stapled anastomosis showed a lower rate of anastomotic leak in E-S patients (OR = 0.185; 95% CI: 0.054–0.627; P = 0.007). CONCLUSIONS: This is the first systematic review to show that the E-S technique produces superior post-operative outcomes after right colectomy compared to S-S. However, the choice of anastomosis was largely surgeon dependent, but surgeon factors were not reported. Wolters Kluwer - Medknow 2022 2022-01-06 /pmc/articles/PMC9306133/ /pubmed/35046183 http://dx.doi.org/10.4103/jmas.jmas_161_21 Text en Copyright: © 2022 Journal of Minimal Access Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Lin, Snow Yunni
Buan, Bryan Jun Liang
Sim, Wilson
Jain, Sneha Rajiv
Chang, Heidi Sian Ying
Lee, Kuok Chung
Chong, Choon Seng
Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title_full Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title_fullStr Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title_full_unstemmed Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title_short Side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: A cohort control study
title_sort side-to-side versus end-to-side ileocolic anastomosis in right-sided colectomies: a cohort control study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9306133/
https://www.ncbi.nlm.nih.gov/pubmed/35046183
http://dx.doi.org/10.4103/jmas.jmas_161_21
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