Retrospective Study Of Two Anastomosis Methods In Open And Laparoscopic Right Hemicolectomy

Objective:To compare and analyze the clinical effect of mechanical end-to-side anastomosis and side-to-side anastomosis in open and laparoscopic assisted right hemicolectomy,and to explore the difference between the two in different surgical procedures.Methods:The clinical records of patients with right colon cancer who underwent open and laparoscopic assisted right colonectomy during the first affiliated hospital of Hainan Medical College from January 2013 to October 2019 were selected,and were analyzed in a clinical retrospective control.The clinical records collected were divided into laparotomy group and laparoscopic group according to the different surgical methods.The laparotomy group was divided into different groups according to the anastomosis method: group A end-to-side anastomosis(69 cases)and side-to-side anastomosis in group B(77 cases);The laparoscopic group was divided into two groups: end-to-side anastomosis in group C(65 cases)and side-to-side anastomosis in group D(81 cases).To compare and analyze the records of intraoperative indicators(operation time,intraoperative blood loss),early recovery indicators(first exhaust time,first defecation time,diet recovery time,the number of defecations at 9 days after operation and postoperative hospitalization days),and the occurrence of postoperative complications(postoperative anastomotic bleeding,anastomotic stenosis,anastomotic leakage,intestinal obstruction,and secondary infection)of patients in the laparotomy group and laparoscopic group.Results: In the laparotomy group,there was no significant difference between group A and group B in operation time,intraoperative blood loss,first defecation time,the number of 9 days after operation and hospitalization days(P>0.05);group A had shorter first exhaust time than group B(P=0.021),group A had faster recovery time of diet than group B(P=0.012)and group A had lower total incidence of postoperative complications than group B(P=0.034).In the laparoscopic group,there was no significant difference between group C and group D in operation time,intraoperative blood loss,first defecation time,time of recovery of diet and days of hospitalization(P>0.05);the time of first postoperative exhaust in group C was shorter than that in group D(P=0.001)and the number of defecations at 9 days after operation in group C was more than that in group D(P=0.032);There was no significant difference in the total incidence of postoperative complications(P=0.913).Conclusions: The study found that mechanical end-to-side anastomosis is better clinical effect than side-to-side anastomosis in open and laparoscopic assisted right hemicolectomy,suggesting that mechanical end-to-side anastomosis can be used as the best way of right hemicolectomy.