Impact of an Institutional Shift to Intracorporeal Anastomosis on Postoperative Outcomes After Laparoscopic Right Colectomy for Cancer
In brief
Intracorporeal anastomosis cuts extraction-site hernia to 2.5% after right colectomy
In a single-center review of 438 cancer patients, switching to intracorporeal anastomosis lowered incisional hernia rates from 13% to 2.5% and shortened hospital stay, while overall complications, leaks, and readmissions were unchanged. The results persisted after multivariable adjustment and propensity matching, suggesting technique standardization can improve recovery without added risk.
- Journal
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (Q1)
- Published
- 22 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Federico Ghignone, Davide Zanotti, Margherita Minghetti, Francesca Rita Di Candido, Giacomo Frascaroli, Federico Mazzotti, et al.
- PMID
- 42772508
- DOI
- 10.1016/j.gassur.2026.102605
Why clinicians should know about it
- Picked for Gastrointestinal and Colorectal Surgery (paper of the day, 24 September 2026): Intracorporeal anastomosis improves right colectomy outcomes
Abstract
PURPOSE: Variation in surgical technique remains an important source of heterogeneity in postoperative outcomes after colorectal surgery. Although enhanced recovery pathways have standardized perioperative care, less attention has been devoted to the systematic standardization of surgical techniques. We evaluated whether the implementation of a standardized institutional program adopting intracorporeal anastomosis during laparoscopic right colectomy for cancer was associated with improved postoperative outcomes. METHODS: This is a single center retrospective pre-post cohort study. The primary outcome was rate of incisional hernia at extraction site. Secondary outcomes included postoperative complications, reintervention, unplanned readmission and postoperative length of stay. Patients were stratified according to anastomotic technique. Multivariable regression models were used to adjust for clinically relevant confounders. A propensity score-matched analysis was performed to mitigate selection bias. RESULTS: A total of 438 patients was included. Institutional implementation of intracorporeal anastomosis correlated with a lower rate of incisional hernia compared to extracorporeal (2.5% vs 13.1%, p<0.001). On adjusted analysis, intracorporeal anastomosis remained independently associated with reduced odds of incisional hernia (OR 0.15, 95% CI 0.05-0.46, p<0.001) and shorter length of stay. No significant differences were observed in overall complications, anastomotic leak, ileus, bleeding, reintervention, or readmission. These findings were consistent in the propensity score-matched cohort. CONCLUSIONS: Institutional standardization of intracorporeal anastomosis during laparoscopic right colectomy was associated with improved recovery and a marked reduction in extraction-site hernia without compromising postoperative safety. These findings suggest that standardizing surgical technique, alongside established enhanced recovery pathways, may represent an effective strategy for improving the quality of colorectal surgical care.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.