Kayano H, Mamuro N, Kamei Y, Ogimi T, Miyakita H, Nakagohri T, Koyanagi K, Mori M, Yamamoto S. Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer: A propensity score matching analysis. World J Gastrointest Surg 2024; 16(3): 670-680 [PMID: 38577098 DOI: 10.4240/wjgs.v16.i3.670]
Corresponding Author of This Article
Hajime Kayano, MD, PhD, Associate Professor, Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Kanagawa, Japan. h.kayano@tsc.u-tokai.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2024; 16(3): 670-680 Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.670
Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer: A propensity score matching analysis
Hajime Kayano, Nana Mamuro, Yutaro Kamei, Takashi Ogimi, Hiroshi Miyakita, Toshio Nakagohri, Kazuo Koyanagi, Masaki Mori, Seiichiro Yamamoto, Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara 259-1193, Kanagawa, Japan
Author contributions: Kayano H designed the study, analyzed the data, and wrote the paper; Mamuro N, Kamei Y, Ogimi T, and Miyakita H collected the data; Mori M, Nakagohri T, and Koyanagi K supervised this study; and Yamamoto S designed the study and supervised writing of the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Review Committee of the Research Ethics Committee, Tokai University School of Medicine (23RC011).
Conflict-of-interest statement: All authors have no conflict of interest related to the manuscript.
Data sharing statement: The datasets analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hajime Kayano, MD, PhD, Associate Professor, Department of Gastroenterological Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Kanagawa, Japan. h.kayano@tsc.u-tokai.ac.jp
Received: December 4, 2023 Peer-review started: December 4, 2023 First decision: December 28, 2023 Revised: January 6, 2024 Accepted: February 4, 2024 Article in press: February 4, 2024 Published online: March 27, 2024
ARTICLE HIGHLIGHTS
Research background
Because intracorporeal anastomosis (IA) involves opening the intestinal tract in the abdominal cavity under pneumoperitoneum, concerns about bacterial infection and the spread of tumor cells remain, and the number of institutions performing IA is limited.
Research motivation
The intraperitoneal bacterial contamination of the abdominal cavity by IA and the resulting perioperative biological reactions, as well as the medium-term oncological outcomes of IA, have not been clarified.
Research objectives
The purpose of this study was to clarify the effects of bacterial and tumor cell contamination of the abdominal cavity in IA.
Research methods
Intracorporeal and extracorporeal anastomoses performed for colon cancer were compared after propensity score matching.
Research results
The 3-year disease-free survival rates did not significantly differ between the IA and extracorporeal anastomosis (EA) groups (87.2% vs 82.7%, respectively, P = 0.4473). The recurrence rate and type of recurrence also did not differ between the two groups. Furthermore, no significant differences were observed in the incidence of surgical site infection or the number of days on antibiotics, but the postoperative biological response was significantly higher in the IA group.
Research conclusions
The IA method showed the same medium-term results as the conventional EA method; no obvious effects of bacterial or tumor cell dispersal were observed.
Research perspectives
IA is not oncologically problematic and may be a less invasive anastomosis than EA.
