Download PDF
Clin Colon Rectal Surg 2023; 36(01): 005-010
DOI: 10.1055/s-0042-1757786
Review Article

Ileocolic Anastomoses

Lauren Gleason
1   Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama Medical Center, Birmingham, Alabama
,
Drew Gunnells Jr
1   Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama Medical Center, Birmingham, Alabama
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Ileocolic anastomoses are commonly performed by surgeons in both open and minimally invasive settings and can be created by using many different techniques and configurations. Here the authors review both current literature and the author's preference for creation of ileocolic anastomoses in the setting of malignancy, inflammatory bowel disease, and colonic inertia. The authors also review evidence surrounding adjuncts to creation of anastomoses such as use of indocyanine green and closing mesenteric defects. While many techniques of anastomotic creation have adapted with new evidence and technologies, several key principles still provide the foundation for current practice.

Keywords

ileocolic - anastomosis - colectomy


Publication History

Article published online:
09 December 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Vargas H, Margolin D. The ASCRS Textbook of Colon and Rectal Surgery. 2022: 141-160
    Google Scholar
  • 2 Slieker JC, Daams F, Mulder IM, Jeekel J, Lange JF. Systematic review of the technique of colorectal anastomosis. JAMA Surg 2013; 148 (02) 190-201
    CrossrefPubMedGoogle Scholar
  • 3 Gustafsson P, Jestin P, Gunnarsson U, Lindforss U. Higher frequency of anastomotic leakage with stapled compared to hand-sewn ileocolic anastomosis in a large population-based study. World J Surg 2015; 39 (07) 1834-1839
    CrossrefPubMedGoogle Scholar
  • 4 Würtz HJ, Bundgaard L, Rahr HB, Frostberg E. Anastomosis technique and leakage rates in minimally invasive surgery for right-sided colon cancer. A retrospective national cohort study. Int J Colorectal Dis 2022; 37 (03) 701-708
    CrossrefPubMedGoogle Scholar
  • 5 Resegotti A, Astegiano M, Farina EC. et al. Side-to-side stapled anastomosis strongly reduces anastomotic leak rates in Crohn's disease surgery. Dis Colon Rectum 2005; 48 (03) 464-468
    CrossrefPubMedGoogle Scholar
  • 6 Choy PY, Bissett IP, Docherty JG, Parry BR, Merrie AE. Stapled versus handsewn methods for ileocolic anastomoses. Cochrane Database Syst Rev 2007; (03) CD004320 DOI: 10.1002/14651858.CD004320.pub2.
    CrossrefPubMedGoogle Scholar
  • 7 Jurowich C, Lichthardt S, Matthes N. et al. Effects of anastomotic technique on early postoperative outcome in open right-sided hemicolectomy. BJS Open 2018; 3 (02) 203-209
    CrossrefPubMedGoogle Scholar
  • 8 Schineis C, Fenzl T, Aschenbrenner K. et al. Stapled intestinal anastomoses are more cost effective than hand-sewn anastomoses in a diagnosis related group system. Surgeon 2021; 19 (06) 321-328
    CrossrefPubMedGoogle Scholar
  • 9 Ibáñez N, Abrisqueta J, Luján J, Hernández Q, Rufete MD, Parrilla P. Isoperistaltic versus antiperistaltic ileocolic anastomosis. Does it really matter? Results from a randomised clinical trial (ISOVANTI). Surg Endosc 2019; 33 (09) 2850-2857
    CrossrefPubMedGoogle Scholar
  • 10 Matsuda A, Miyashita M, Matsumoto S. et al. Isoperistaltic versus antiperistaltic stapled side-to-side anastomosis for colon cancer surgery: a randomized controlled trial. J Surg Res 2015; 196 (01) 107-112
    CrossrefPubMedGoogle Scholar
  • 11 Carchman E, Kalady M. Colon Cancer Surgical Treatment: Principles of The ASCRS Textbook of colon and Rectal Surgery. 2022: 451-462
    CrossrefGoogle Scholar
  • 12 Aiolfi A, Bona D, Guerrazzi G. et al. Intracorporeal versus extracorporeal anastomosis in laparoscopic right colectomy: an updated systematic review and cumulative meta-analysis. J Laparoendosc Adv Surg Tech A 2020; 30 (04) 402-412
    CrossrefPubMedGoogle Scholar
  • 13 Loftus Jr EV, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16 (01) 51-60
    CrossrefPubMedGoogle Scholar
  • 14 Valibouze C, Desreumaux P, Zerbib P. Post-surgical recurrence of Crohn's disease: Situational analysis and future prospects. J Visc Surg 2021; 158 (05) 401-410
    CrossrefPubMedGoogle Scholar
  • 15 Lopez J, Konijeti GG, Nguyen DD, Sauk J, Yajnik V, Ananthakrishnan AN. Natural history of Crohn's disease following total colectomy and end ileostomy. Inflamm Bowel Dis 2014; 20 (07) 1236-1241
    CrossrefPubMedGoogle Scholar
  • 16 Simillis C, Purkayastha S, Yamamoto T, Strong SA, Darzi AW, Tekkis PP. A meta-analysis comparing conventional end-to-end anastomosis vs. other anastomotic configurations after resection in Crohn's disease. Dis Colon Rectum 2007; 50 (10) 1674-1687
    CrossrefPubMedGoogle Scholar
  • 17 He X, Chen Z, Huang J. et al. Stapled side-to-side anastomosis might be better than handsewn end-to-end anastomosis in ileocolic resection for Crohn's disease: a meta-analysis. Dig Dis Sci 2014; 59 (07) 1544-1551
    CrossrefPubMedGoogle Scholar
  • 18 Kono T, Ashida T, Ebisawa Y. et al. A new antimesenteric functional end-to-end handsewn anastomosis: surgical prevention of anastomotic recurrence in Crohn's disease. Dis Colon Rectum 2011; 54 (05) 586-592
    CrossrefPubMedGoogle Scholar
  • 19 Kono T, Fichera A, Maeda K. et al. Kono-S anastomosis for surgical prophylaxis of anastomotic recurrence in Crohn's disease: an international multicenter study. J Gastrointest Surg 2016; 20 (04) 783-790
    CrossrefPubMedGoogle Scholar
  • 20 Shimada N, Ohge H, Kono T. et al. Surgical recurrence at anastomotic site after bowel resection in Crohn's disease: comparison of Kono-S and end-to-end anastomosis. J Gastrointest Surg 2019; 23 (02) 312-319
    CrossrefPubMedGoogle Scholar
  • 21 Alshantti A, Hind D, Hancock L, Brown SR. The role of Kono-S anastomosis and mesenteric resection in reducing recurrence after surgery for Crohn's disease: a systematic review. Colorectal Dis 2021; 23 (01) 7-17
    CrossrefPubMedGoogle Scholar
  • 22 Luglio G, Rispo A, Imperatore N. et al. Surgical prevention of anastomotic recurrence by excluding mesentery in Crohn's disease: the SuPREMe-CD study - a randomized clinical trial. Ann Surg 2020; 272 (02) 210-217
    CrossrefPubMedGoogle Scholar
  • 23 Pemberton JH, Rath DM, Ilstrup DM. Evaluation and surgical treatment of severe chronic constipation. Ann Surg 1991; 214 (04) 403-411 , discussion 411–413
    CrossrefPubMedGoogle Scholar
  • 24 McCoy JA, Beck DE. Surgical management of colonic inertia. Clin Colon Rectal Surg 2012; 25 (01) 20-23
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Paquette IM, Varma M, Ternent C. et al. The American Society of Colon and Rectal Surgeons' clinical practice guideline for the evaluation and management of constipation. Dis Colon Rectum 2016; 59 (06) 479-492
    CrossrefPubMedGoogle Scholar
  • 26 Elton C, Makin G, Hitos K, Cohen CR. Mortality, morbidity and functional outcome after ileorectal anastomosis. Br J Surg 2003; 90 (01) 59-65
    CrossrefPubMedGoogle Scholar
  • 27 Segelman J, Mattsson I, Jung B, Nilsson PJ, Palmer G, Buchli C. Risk factors for anastomotic leakage following ileosigmoid or ileorectal anastomosis. Colorectal Dis 2018; 20 (04) 304-311
    CrossrefPubMedGoogle Scholar
  • 28 Payne JH, DeWind LT, Commons RR. Metabolic observations in patients with jejunocolic shunts. 1963. Obes Res 1996; 4 (03) 304-315
    CrossrefPubMedGoogle Scholar
  • 29 Wiggins T, Majid MS, Agrawal S. From the knife to the endoscope-a history of bariatric surgery. Curr Obes Rep 2020; 9 (03) 315-325
    CrossrefPubMedGoogle Scholar
  • 30 Hasegawa H, Tsukada Y, Wakabayashi M. et al. Impact of intraoperative indocyanine green fluorescence angiography on anastomotic leakage after laparoscopic sphincter-sparing surgery for malignant rectal tumors. Int J Colorectal Dis 2020; 35 (03) 471-480
    CrossrefPubMedGoogle Scholar
  • 31 Jafari MD, Wexner SD, Martz JE. et al. Perfusion assessment in laparoscopic left-sided/anterior resection (PILLAR II): a multi-institutional study. J Am Coll Surg 2015; 220 (01) 82-92 .e1
    CrossrefPubMedGoogle Scholar
  • 32 Golda T, Lazzara C, Zerpa C. et al. Risk factors for ileocolic anastomosis dehiscence; a cohort study. Am J Surg 2020; 220 (01) 170-177
    CrossrefPubMedGoogle Scholar
  • 33 Baqar AR, Wilkins S, Wang WC. et al. A comparison of extracorporeal side to side or end to side anastomosis following a laparoscopic right hemicolectomy for colon cancer. ANZ J Surg 2022; 92 (06) 1472-1479
    CrossrefPubMedGoogle Scholar
  • 34 Widmar M, Cummings DR, Steinhagen E. et al. Oversewing staple lines to prevent anastomotic complications in primary ileocolic resections for Crohn's disease. J Gastrointest Surg 2015; 19 (05) 911-916
    CrossrefPubMedGoogle Scholar
  • 35 Yang ML, Brar MS, Boughn A. et al. Does oversewing stapled ileocolic anastomoses for Crohn's disease reduce anastomotic complications? An inverse-probability weighting analysis of a single centre cohort. J Gastrointest Surg 2022; DOI: 10.1007/s11605-022-05247-7.
    CrossrefPubMedGoogle Scholar
  • 36 2015 European Society of Coloproctology Collaborating Group. The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit. Colorectal Dis 2018; 20 (11) 1028-1040
    CrossrefPubMedGoogle Scholar
  • 37 Cabot JC, Lee SA, Yoo J, Nasar A, Whelan RL, Feingold DL. Long-term consequences of not closing the mesenteric defect after laparoscopic right colectomy. Dis Colon Rectum 2010; 53 (03) 289-292
    CrossrefPubMedGoogle Scholar
  • 38 Keller DS, Dapri G, Grucela AL. et al; Colorectal Committee Right Colon Subcommittee. The SAGES MASTERS program presents: the 10 seminal articles for the laparoscopic right colectomy pathway. Surg Endosc 2022; 36 (07) 4639-4649
    CrossrefPubMedGoogle Scholar
  • 39 Tsai K-L, Lai W-H, Lee K-C. et al. Long-term consequences of nonclosure of mesenteric defects after traditional right colectomy. BioMed Res Int 2018; 2018: 9123912
    PubMedGoogle Scholar
  • 40 Causey MW, Oguntoye M, Steele SR. Incidence of complications following colectomy with mesenteric closure versus no mesenteric closure: does it really matter?. J Surg Res 2011; 171 (02) 571-575
    CrossrefPubMedGoogle Scholar
  • 41 Portale G, Popescu GO, Parotto M, Cavallin F. Internal hernia after laparoscopic colorectal surgery: an under-reported potentially severe complication. A systematic review and meta-analysis. Surg Endosc 2019; 33 (04) 1066-1074
    CrossrefPubMedGoogle Scholar