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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P587
Anastomotic Technique in Laparoscopic Right Colectomy for Cancer: A Multicenter, Propensity-Weighted Comparison of Intracorporeal versus Mechanical and Hand-sewn Extracorporeal Techniques
Part of Topic
Foregut
Background:
The optimal anastomotic technique in laparoscopic right colectomy (LRC) remains controversial.
Intracorporeal anastomosis (ICA) has been associated with faster bowel recovery and fewer incisional hernias, yet its safety regarding anastomotic leak and its impact on oncologic outcomes — particularly lymph node yield — are still debated.
Objectives:
To determine which technique offers the best balance of safety, recovery, and oncologic results.
Methods:
•Study Design: Multicenter comparison of 182 patients : ICA (n=69), MECA (n=61), and HECA (n=52).
•Statistical Analysis: Propensity-weighted analysis using Inverse Probability of Treatment Weighting (IPTW) to balance baseline covariates. Figure 1
•Primary Endpoints: Bowel function recovery and anastomotic leak safety.
•Secondary Endpoints: Lymph node yield and long-term incisional hernia incidence
Results:
•Study Population: 182 patients analyzed (69 ICA, 61 MECA, 52 HECA) , with baseline characteristics well-balanced after IPTW adjustment. Table 1
•Bowel Recovery: Mechanical techniques (ICA and MECA) achieved significantly faster recovery of bowel function compared to HECA (p<0.001$).
•Anastomotic Safety: No significant differences were observed in leak incidence (ICA 9.2%, MECA 4.3%, HECA 7.2%; p=0.83). Figure 2
•Oncologic & Long-term Outcomes: Comparable results across all groups for total lymph nodes harvested and long-term incidence of incisional hernia. Table 2
•Hospital Stay: No significant difference was found in Length of Stay (LOS) after weighting
Conclusions.
•Functional Superiority: Mechanical techniques (ICA and MECA) significantly accelerate the recovery of bowel function (p<0.001).
•Safety & Oncology: ICA offers a safety profile comparable to extracorporeal techniques (MECA/HECA), with no significant differences in anastomotic leaks or lymph node yield.
•Clinical Verdict: ICA is a safe and functionally advantageous alternative for laparoscopic right colectomy. Its adoption optimizes early post-operative recovery while maintaining strict oncologic standards.