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Purpose <p>The safety and benefits of intracorporeal anastomosis (ICAN) in overweight and obese colon cancer patients remain unclear. This study aimed to evaluate the short-term outcomes of ICAN compared to extracorporeal anastomosis (ECAN) in this population.</p> Methods <p>This nationwide multicenter retrospective cohort study included 46 institutions. Body mass index (BMI) ≥ 25&#xa0;kg/m<sup>2</sup> in patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy were assessed using propensity score matching to compare ICAN and ECAN.</p> Results <p>Between January 2020 and December 2021, 361 patients were analyzed (ICAN, <i>n</i> = 191; ECAN, <i>n</i> = 170). ICAN was associated with a longer operative time (252 vs. 232&#xa0;min, <i>p</i> &lt; 0.001), but significantly less blood loss (5 vs. 15.5&#xa0;ml, <i>p</i> &lt; 0.001) and a shorter wound length (4 vs. 5&#xa0;cm, <i>p</i> &lt; 0.001). There were no significant differences in the intraoperative (1.6 vs. 1.8%) or postoperative complication rates (9.4 vs. 7.6%). The time to first stool passage was shorter in the ICAN group (3 (IQR 2–4) vs. 3 (IQR 3–5) days, <i>p</i> &lt; 0.001).</p> Conclusions <p>ICAN is safe and beneficial for overweight and obese patients undergoing laparoscopic colectomy, offering reduced blood loss, smaller incisions, and a faster bowel recovery.</p> <p><b>Trial registration: </b>This study was registered in the UMIN Clinical Trials Registry System in 2022 (UMIN000047994).</p>

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A multicenter trial evaluating the short-term outcomes of intracorporeal versus extracorporeal anastomosis in laparoscopic colectomy for overweight and obese patients with colon cancer: a secondary analysis of the ICAN study

  • 期刊论文

  • 发表日期：

    2025年8月21日

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  • Emi Ota,
  • Jun Watanabe,
  • Hirokazu Suwa,
  • Keitaro Tanaka,
  • Tomohiro Yamaguchi,
  • Hiroki Hamamoto,
  • Atsushi Nishimura,
  • Fumihiko Fujita,
  • Heita Ozawa,
  • Kenji Kobayashi,
  • Tomoaki Okada,
  • Yukitoshi Todate,
  • Takeshi Naitoh

摘要

Purpose

The safety and benefits of intracorporeal anastomosis (ICAN) in overweight and obese colon cancer patients remain unclear. This study aimed to evaluate the short-term outcomes of ICAN compared to extracorporeal anastomosis (ECAN) in this population.

Methods

This nationwide multicenter retrospective cohort study included 46 institutions. Body mass index (BMI) ≥ 25 kg/m2 in patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy were assessed using propensity score matching to compare ICAN and ECAN.

Results

Between January 2020 and December 2021, 361 patients were analyzed (ICAN, n = 191; ECAN, n = 170). ICAN was associated with a longer operative time (252 vs. 232 min, p < 0.001), but significantly less blood loss (5 vs. 15.5 ml, p < 0.001) and a shorter wound length (4 vs. 5 cm, p < 0.001). There were no significant differences in the intraoperative (1.6 vs. 1.8%) or postoperative complication rates (9.4 vs. 7.6%). The time to first stool passage was shorter in the ICAN group (3 (IQR 2–4) vs. 3 (IQR 3–5) days, p < 0.001).

Conclusions

ICAN is safe and beneficial for overweight and obese patients undergoing laparoscopic colectomy, offering reduced blood loss, smaller incisions, and a faster bowel recovery.

Trial registration: This study was registered in the UMIN Clinical Trials Registry System in 2022 (UMIN000047994).