Abstract:
Objective To compare the clinical efficacy and safety of retro-peristaltic and pro- peristaltic intracavitary ileocolic-cecal anastomosis in total laparoscopic right hemicolectomy (TLRC).
Methods A retrospective cohort design was adopted to collect the clinical data of 94 patients with right- sided colon cancer from January 2020 to December 2024. All patients underwent TLRC and intracavitary ileocolic-cecal side-to-side anastomosis (ⅡA-SS) for digestive tract reconstruction. The patients were divided into two groups based on different ⅡA-SS anastomosis methods: Anti-Peristaltic group (n=47, retro-peristaltic ileocolic-cecal anastomosis) and Overlap group (n=47, pro-peristaltic ileocolic-cecal anastomosis). Data were analyzed using statistical software SPSS 27. 0. Continuous variables were expressed as (
±
s), and independent sample
t tests were used for group comparisons; rank-based data were expressed as constituent ratios, and
Rank Sum tests were used for group comparisons; repeated measurement data were analyzed using repeated measures analysis of variance; categorical variables were expressed as frequencies (percentages), and
χ2 tests or
Fisher's exact tests were used for group comparisons.
P<0.05 was considered statistically significant.
Results There were no statistically significant differences in intraoperative blood loss, operation time, hospital stay, Clavien-Dindo grade Ⅰ-Ⅲ complications, and postoperative complications (infection, chronic diarrhea, intestinal obstruction, etc.) between the two groups, as well as in the preoperative EORTC QLQ-C30 scores of the four dimensions (function, overall health, symptoms, and trauma), and the postoperative 6-month scores of the functional and overall health dimensions. Compared with the Overlap group, the Anti-Peristaltic group had a longer digestive tract reconstruction time, shorter ventilation time, and shorter defecation time (P<0.05). There was no interaction effect between time and method in the GIQLI score (P>0.05), the main effect of time on the GIQLI score was significant (P<0.05), the main effect of the method on the GIQLI score was significant (P<0.05); at 6 months postoperatively, the symptom and trauma scores of the EORTC QLQ-C30 scale in the Anti-Peristaltic group were lower than those in the Overlap group (P<0.05).
Conclusion Anti-Peristaltic anastomosis can promote the recovery of intestinal function after TLRC and improve long-term quality of life, but caution should be exercised regarding the risk of anastomotic leakage. It is recommended to apply under strict operational control.
Key words:
Colonic Neoplasms,
Laparoscopes,
Colectomy,
Overlap Anastomosis,
Anti- Peristaltic Anastomosis
Xiancheng Kong, Li Sha, Lei Du, Hao Zhang. Clinical comparative study of retrograde and prograde intracavitary ileocolic anastomosis in TLRC[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2026, 20(03): 267-270.