Effects of end-side and side-side anastomosis following a laparoscopic right hemicolectomy on postoperative intestinal function and quality of life

LI Zhi-wei; CHENG Wei; GE Wei; SHAO Li-hua; MA Xiao-long; FAN Sheng-xian; CHEN Gang; WANG Hao

doi:10.19538/j.cjps.issn1005-2208.2024.08.20

Abstract：Objective To compare the effects of end-side anastomosis(ES)and side-side anastomosis(SS)following laparoscopic right hemicolectomy on postoperative intestinal function and quality of life in patients with right colon cancer.Methods A retrospective cohort study was conducted using the clinical data of patients with right colon cancer who underwent laparoscopic right hemicolectomy at Nanjing Drum Tower Hospital from June 2022 to June 2023.Patients were divided into two groups based on the anastomosis technique:the ES group(31 cases)and the SS group(64 cases).Postoperative intestinal function was assessed by the time to first flatus,time to first defecation,and the frequency and duration of diarrhea.Quality of life was evaluated using the Gastrointestinal Quality of Life Index(GIQLI).Differences in postoperative intestinal function and quality of life between the two groups were compared.Results There were no significant differences between the two groups in baseline characteristics such as age,gender,body mass index,postoperative pathological stage,American College of Anesthesiologists classification,intraoperative blood loss,number of lymph nodes harvested,postoperative complications,and length of hospital stay(P＞0.05).The time to first flatus[4.0(3.85,4.35)d vs.3.6(3.40,3.725)d]and the time to first defecation[4.5(4.30,4.80)d vs.4.1(4.00,4.30)d]in the ES group were significantly later than those in the SS group,and the difference was statistically significant(P＜0.001).Postoperative daily diarrhea frequency[4(3.0,4.0)times/d vs.5(4,6)times/d]and postoperative diarrhea duration[3(2.0,4.0)d vs.4.5(4.0,6.0)d]in ES group were lower than those in SS group,and the difference was statistically significant(P＜0.05).The GIQLI scores of the ES group at 2 weeks,1 month,and 3 months postoperatively were 69.0(65.50,73.50)points,99.0(93.00,100.00)points and 110.0(106.50,117.50)points,respectivel.The GIQLI scores of the SS group 63.0(61.00,67.00)points,76.5(72.50,81.50)points,and 104.0(96.75,109.25)points.The GIQLI scores in the ES group were higher than those in the SS group at all time points,with statistical significance(P＜0.001).Conclusion ES may be more beneficial than SS in improving postoperative intestinal function and quality of life in patients undergoing laparoscopic right hemicolectomy for right colon cancer.