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World J Clin Cases. Mar 16, 2023; 11(8): 1694-1701
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1694
Isoperistaltic vs antiperistaltic anastomosis after right hemicolectomy: A comprehensive review
Dimitrios Symeonidis, Kostas-Sotirios Karakantas, Labrini Kissa, Athina A Samara, Effrosyni Bompou, Konstantinos Tepetes, Georgios Tzovaras
Dimitrios Symeonidis, Kostas-Sotirios Karakantas, Labrini Kissa, Athina A Samara, Effrosyni Bompou, Konstantinos Tepetes, Georgios Tzovaras, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Symeonidis D, Tzovaras G, Karakantas K-S, Samara AA and Tepetes K wrote the original paper and contributed to study conception and design; Kissa L and Bompou E performed the research; All authors have approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
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: Athina A Samara, MD, Surgeon, Department of Surgery, University Hospital of Larissa, Mezourlo Hill, Larissa 41110, Greece. at.samara93@gmail.com
Received: November 5, 2022
Peer-review started: November 5, 2022
First decision: January 11, 2023
Revised: January 28, 2023
Accepted: February 21, 2023
Article in press: February 21, 2023
Published online: March 16, 2023
Processing time: 121 Days and 22.6 Hours
Abstract

To optimize the efficiency of ileocolic anastomosis following right hemicolectomy, several variations of the surgical technique have been tested. These include performing the anastomosis intra- or extracorporeally or performing a stapled or hand-sewn anastomosis. Among the least studied is the configuration of the two stumps (i.e., isoperistaltic or antiperistaltic) in the case of a side-to-side anastomosis. The purpose of the present study is to compare the isoperistaltic and antiperistaltic side-to-side anastomotic configuration after right hemicolectomy by reviewing the relevant literature. High-quality literature is scarce, with only three studies directly comparing the two alternatives, and no study has revealed any significant differences in the incidence of anastomosis-related complications such as leakage, stenosis, or bleeding. However, there may be a trend towards an earlier recovery of intestinal function following antiperistaltic anastomosis. Finally, existing data do not identify a certain anastomotic configuration (i.e., isoperistaltic or antiperistaltic) as superior over the other. Thus, the most appropriate approach is to master both anastomotic techniques and select between the two configurations based on each individual case scenario.

Keywords: Isoperistaltic side-to-side anastomosis; Antiperistaltic side-to-side anastomosis; Ileocolic anastomosis; Right hemicolectomy; Scenario

Core Tip: This review assesses and compares two side-to-side anastomotic configurations (isoperistaltic and antiperistaltic) following right hemicolectomy. Current literature does not identify any anastomotic configuration as superior over the other. Thus, the most appropriate approach is to master both anastomotic techniques and select between the configurations based on each individual case scenario.