Oncological merits of intracorporeal anastomosis versus extracorporeal anastomosis for right-sided colon cancer

Surg Today. 2025 Nov;55(11):1589-1597. doi: 10.1007/s00595-025-03054-6. Epub 2025 May 24.

Abstract

Purpose: The incidence of colorectal cancer (CRC) is increasing worldwide. Surgical resection is the primary treatment for localized cases with the aim of complete tumor removal and adequate lymph node dissection. Intracorporeal anastomosis (IA) has gained popularity in colorectal surgery; however, its oncological benefits over extracorporeal anastomosis (EA) remain unclear.

Methods: This retrospective study at Ehime University Hospital included 118 right-sided colon cancer patients (54 IA and 64 EA) treated between 2018 and 2023. Outcomes such as distal margin (DM) length and number of lymph nodes dissected were assessed.

Results: In the IA group, the DM was significantly longer (117.9 ± 49.5 mm vs. 78.2 ± 30.1 mm, p < 0.001) and more lymph nodes were harvested (22.2 ± 10.0 vs. 18.2 ± 9.9, p = 0.031). A multivariate analysis identified IA as an independent factor for DM > 10 cm (odds ratio [OR] = 0.25, p = 0.001) and > 12 dissected lymph nodes (OR = 0.15, p = 0.006). Patients with IA resumed ingestion and defecation sooner, with shorter hospital stays.

Conclusions: IA provides significant advantages for DM length and lymph node dissection, suggesting that it may be preferable for right-sided colon cancer surgery.

Keywords: Colorectal cancer; Distal resection margin; Intracorporeal anastomosis; Lymph node dissection; Right-sided colon cancer.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical* / methods
  • Colectomy* / methods
  • Colon* / surgery
  • Colonic Neoplasms* / pathology
  • Colonic Neoplasms* / surgery
  • Female
  • Humans
  • Length of Stay
  • Lymph Node Excision
  • Male
  • Margins of Excision
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome