Laparoscopic left colectomy with intracorporeal anastomosis: initial experience

Abstract

Background: Laparoscopic surgery has advanced in colorectal pathology. Reports of intracorporeal anastomosis in laparoscopic right colectomy are more common, as it appears to be less challenging. Intracorporeal anastomosis in left colectomy could maximize the benefits of laparoscopy while maintaining the same surgical safety. Aim: The objective of this study was to analyze the results of our initial experience in laparoscopic left colectomy with intracorporeal anastomosis.

Design: Retrospective descriptive study.

Method: Patients with a diagnosis of benign and malignant pathology of the left colon treated by surgical resolution, in a single center, between March 2021 and March 2022, were analyzed. The variables analyzed were demographics, operative techniques, postoperative complications, operative time and hospitalization time.

Results: A total of n= 18 patients were analyzed, with an average age of 55 years (44.5% women, 55.5% men). In 61.1% it was benign pathology while the remaining 38.9% was malignant pathology. The type of anastomosis performed was side-to-side (72.2%), side-to-end (22.2%), and end-to-end (5.5%). Manual suture was performed in 72.2% of the patients, while mechanical suture was performed in 27.7%. The mean total operative time was 126.5 hours (p= > 0.05). Hospitalization time was 6 days on average (p= > 0.05). A complication rate of 33.3% and a relaparoscopy rate of 16.6% were reported. No conversions recorded. Mortality was 0%.

Conclusions: Laparoscopic left colectomy with intracorporeal anastomosis is a safe technique. It allows you to take advantage of the advantages offered by laparoscopy. It requires an experienced surgical team with a high level of training in laparoscopic surgery and appropriate technology.