[Comparison of intra-abdominal infection between intracorporeal anastomosis and extracorporeal anastomosis in patients undergoing laparoscopic right hemicolectomy].

Objective To compare the difference of intra-abdominal infection between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in patients undergoing laparoscopic right hemicolectomy within postoperative 30 days. Methods Clinical date of right colon cancer patients undergoing laparoscopic right hemicolectomy at the Department of Colorectal Surgery, PUMCH from January 1st, 2013 to October 31st, 2016 were retrospectively analyzed. Patients with stage IV cancers which could not be radically resected, emergency operation and conversion to open surgery were excluded. The intracorporeal anastomosis and extracorporeal anastomosis were compared in the items of operation time, postoperative infection and postoperative hospital stay. Results A total of 194 patients were enrolled in the study, including 73 patients with IA and 121 patients with EA. No significant differences were found in gender, age, previous operation history, tumor site and T stage of the tumor between two groups (all P > 0.05) . There were also no significant differences in mean operative time (162.4 minutes vs. 167.7 minutes, P= 0.257) , time to first flatus (3.3 days vs. 3.4 days, P= 0.744) , number of harvested lymph nodes (30.3 nodes vs. 33.8 nodes, P= 0.071) and postoperative hospital stay (7 days vs. 7 days, P= 0.067) between two groups. The incidence of intra-abdominal infection in patients with IA was significantly higher than that in those with EA[13.7% (10/73) vs. 1.7% (2/121) , P= 0.001], while the differences of the incidence of wound infection[1.4% (1/73) vs. 3.3% (4/121) , P= 0.652], respiratory infection[1.4% (1/73) vs. 3.3% (4/121) , P= 0.652]and urinary tract infection [2.7% (2/73) vs. 0.8% (1/121) , P= 0.558]were not significant. Conclusion Compared with EA, IA may increase the risk of intra-abdominal infection in patients undergoing laparoscopic right hemicolectomy. Key words: Colonic neoplasms; Laparoscopic right hemicolectomy; Intracorporeal anastamosis; Extra abdominal anastomosis; Abdominal infection