| Title |
Intracorporeal versus extracorporeal anastomosis after laparoscopic left colectomy for splenic flexure cancer: results from a multi-institutional audit on 181 consecutive patients
|
|---|---|
| Published in |
Surgical Endoscopy, January 2018
|
| DOI | 10.1007/s00464-018-6065-8 |
| Pubmed ID | |
| Authors |
Marco Milone, Pierluigi Angelini, Giovanna Berardi, Morena Burati, Francesco Corcione, Paolo Delrio, Ugo Elmore, Maria Lemma, Michele Manigrasso, Alfredo Mellano, Andrea Muratore, Ugo Pace, Daniela Rega, Riccardo Rosati, Ernesto Tartaglia, Giovanni Domenico De Palma |
| Abstract |
Although intracorporeal anastomosis has been demonstrated to be safe and effective after right colectomy, limited data are available about its efficacy after left colectomy for colon cancer located in splenic flexure. A multi-institutional audit was designed, including 92 patients who underwent laparoscopic left colectomy with intracorporeal anastomosis (IA) compared with 89 matched patients who underwent a laparoscopic left colectomy with extracorporeal anastomosis (EA). There was no significant difference in terms of age, sex, BMI, and ASA score between the two groups. Post-surgical history and stage of disease according to AJCC/UICC TNM were also similar. IA and EA groups demonstrated similar oncologic radicality in terms of the number of lymph nodes harvested (18.5 ± 9 vs. 17.5 ± 8.4; p = 0.48). Recovery after surgery was also better in patients who underwent IA, as confirmed by the shorter time to flatus in the IA group (2.6 ± 1.1 days vs. 3.4 ± 1.2 days; p < 0.001) and higher post-operative pain expressed in the mean VAS Scale in the EA group (1.7 ± 2.1 vs. 3.5 ± 1.6; p < 0.001). Laparoscopic left colectomy with intracorporeal anastomosis was associated with a lower rate of post-operative complications (OR 6.7, 95% CI 2.2-20; p = 0.001). However, when stratifying according to Clavien classification, the difference was consistently confirmed for less severe (class I and II) complications (OR 7.6, 95% CI 2.5-23, p = 0.001) but not for class III, IV, and V complications (OR 1.8, 95% CI 0.1-16.9; p = 0.59). Our results were consistent to hypothesize that a complete laparoscopic approach could be considered a safe method to perform laparoscopic left colectomy with the advantage of a guaranteed faster recovery after surgery. Further randomized clinical trials are needed to obtain a more definitive conclusion. |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 2 | 17% |
| India | 1 | 8% |
| Brazil | 1 | 8% |
| United States | 1 | 8% |
| Unknown | 7 | 58% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 42% |
| Practitioners (doctors, other healthcare professionals) | 3 | 25% |
| Scientists | 2 | 17% |
| Science communicators (journalists, bloggers, editors) | 2 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 35 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 17% |
| Student > Postgraduate | 5 | 14% |
| Researcher | 4 | 11% |
| Professor | 2 | 6% |
| Student > Doctoral Student | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 13 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 43% |
| Nursing and Health Professions | 1 | 3% |
| Business, Management and Accounting | 1 | 3% |
| Economics, Econometrics and Finance | 1 | 3% |
| Computer Science | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 16 | 46% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 July 2018.
All research outputs
#4,498,955
of 23,016,919 outputs
Outputs from Surgical Endoscopy
#694
of 6,105 outputs
Outputs of similar age
#100,288
of 441,888 outputs
Outputs of similar age from Surgical Endoscopy
#38
of 161 outputs
Altmetric has tracked 23,016,919 research outputs across all sources so far. Compared to these this one has done well and is in the 80th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,105 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done well, scoring higher than 88% of its peers.
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