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Session: ePoster: Quality and Cost 8 (Tue8)

EP961 - Comparative Outcomes of Intracorporeal vs. Extracorporeal Anastomosis in Robotic Colorectal Surgery

Tuesday, May 13, 2025
8:05 AM – 8:10 AM PT

    ePoster Presenter(s)

  • CM

    Charmee H. Mehta, MD

    General Surgery Resident
    ECU Health Medical Center
    Greenville, NC, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • AB

    Annmarie Butare, DO

    General Surgery Resident
    East Carolina University
    Winterville, North Carolina, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • WA

    Warqaa Akram, MD, FACS

    Assistant Professor - Division of Surgical Oncology - ECU
    East Carolina University
    Greenville, NC, North Carolina, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Charmee H. Mehta, MD: This individual has no financial relationships with ineligible companies.
Warqaa Akram, MD, FACS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Minimally invasive robotic colorectal surgery offers advantages over open surgery, including faster recovery times, less pain, and shorter hospital stays. However, the benefits of intracorporeal anastomosis compared to traditional extracorporeal anastomosis remain unclear. Currently, there are no guidelines for resident and fellow training regarding exposure to different anastomosis types. This study aims to compare demographics and outcomes associated with each type of anastomosis.

Methods/Interventions: This was a retrospective study of patients who underwent robotic colorectal surgery at a teaching facility from August 2021 to August 2023. Exclusion criteria included conversion to open surgery, lack of creation of anastomosis, and neoadjuvant radiation. Demographic variables included age, sex, race, body mass index, American Society of Anesthesiologists (ASA) score, and smoking status. Surgical variables included diagnosis and type of surgery. Outcome measures were days to tolerate a diet beyond liquids, length of stay, 90-day readmission, and postoperative complications. Postoperative events were compiled into a composite variable that included emergency department visits, interventions, readmission, anastomotic leak, infection, and reoperation.

Results/Outcomes: A total of 305 robotic colorectal cases were identified from August 2021 to August 2023. After exclusions, 230 patients were included in the analysis, with 77 (33.5%) receiving intracorporeal anastomosis and 153 (66.5%) receiving extracorporeal anastomosis. Univariate analysis revealed significant differences in race, diagnosis, and type of surgery between the two groups. Outcome measures indicated that patients with intracorporeal anastomosis tolerated a diet sooner (1.87 vs. 2.84 days, p< 0.001) but had a higher rate of 90-day readmission (14.2% vs. 5.2%, p=0.020). There was no significant difference in length of stay or in the composite variable of postoperative complications.

Conclusion/Discussion: Our findings suggest benefits to both intracorporeal and extracorporeal anastomosis. Training programs should ensure future surgeons are proficient in both techniques. The next phase of this study will aim to increase statistical power by including an additional year of data, targeting a total of 465 cases.