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Related Experiment Video

Updated: Jul 4, 2026

Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
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Comparison of Minimally Invasive Colectomy Between Intra- Versus Extra-Corporeal Anastomosis Technique (COMMIT

Takuya Takami1, Takehito Yamamoto1, Yoshiro Itatani1

  • 1Department of Surgery, Graduate School of Medicine Kyoto University Kyoto Japan.

Annals of Gastroenterological Surgery
|July 3, 2026
PubMed
Summary

Intracorporeal anastomosis (IA) in minimally invasive colectomy shows potential for reducing distant recurrence in colon cancer patients. This approach appears oncologically safe, comparable to extracorporeal anastomosis (EA), even for advanced tumors.

Keywords:
anastomosiscolon cancerminimally invasive surgerypropensity score matchingrecurrence‐free survival

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Intracorporeal anastomosis (IA) is increasingly used in minimally invasive colectomy for colon cancer.
  • Mid-term oncological outcomes of IA versus extracorporeal anastomosis (EA) require further clarification.

Purpose of the Study:

  • To compare the mid-term oncological outcomes of IA and EA in patients undergoing minimally invasive colectomy for colon cancer.
  • To evaluate recurrence rates and survival between IA and EA.

Main Methods:

  • Multicenter retrospective cohort study (2018-2022) using the Kyoto Colorectal Surgery Group database.
  • Propensity score matching (1:4) to balance patient, tumor, and surgical characteristics.
  • Primary outcome: 2-year recurrence-free survival (RFS); Secondary outcomes: peritoneal, anastomotic, and distant recurrence rates.

Main Results:

  • Matched cohort: 224 IA and 862 EA cases.
  • 2-year RFS tended to be better in the IA group (HR 0.66, not significant).
  • Similar peritoneal and anastomotic recurrence rates; lower distant recurrence in the IA group (RD -4.79%).
  • Subgroup analysis indicated greater distant recurrence reduction in advanced tumors with IA.

Conclusions:

  • IA shows comparable risks for peritoneal and anastomotic recurrence to EA.
  • IA may reduce distant recurrence without compromising 2-year RFS.
  • IA is an oncologically reasonable option for colon cancer, including advanced stages.