Hemopatch serosal reinforcement in right colectomy: transforming anastomotic leak patterns and severity compared to...

Anastomotic leakage remains a significant complication following colorectal surgery. This study evaluates safety and leak mitigation of Hemopatch serosal reinforcement compared to conventional suture reinforcement in patients undergoing right colectomy. This retrospective cohort study analyzed 352 consecutive patients who underwent elective right colectomy between January 2013 and December 2024. Outcomes were compared between Hemopatch reinforcement (n = 181) and standard suture reinforcement (n = 171). Primary outcomes included anastomotic leak rates categorized by International Study Group of Rectal Cancer (ISREC) classification. Overall leak rates were numerically lower with Hemopatch (3.9% vs 8.2%, p = 0.11), with significantly fewer clinically significant leaks requiring intervention (ISREC B + C: 1.1% vs 5.3%, p = 0.03). CT-confirmed leaks were significantly less frequent in the Hemopatch group (5.0% vs 13.5%, p < 0.01). No Hemopatch patients required relaparotomy for anastomotic leak compared to 28.6% in the standard group (p = 0.06). Multivariate analysis identified obesity as the strongest independent risk factor for anastomotic leak (OR = 29.697, p = 0.015). Hemopatch appears to be a viable alternative to traditional suture reinforcement in right colectomy, with comparable safety and a potential advantage in reducing clinically significant leaks. Rather than preventing all leaks, it may transform technical failures into more manageable outcomes with less severe clinical consequences.