ArticleLa Tunisie medicale2025
Isoperistaltic versus antiperistaltic side-to-side ileocolic anastomosis in Crohn's disease and right colon adenocarcinoma: Controlled clinical trial.
Article in La Tunisie medicale, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness and safety of isoperistaltic versus antiperistaltic side-to-side ileocolic anastomosis in minimally invasive radical right hemicolectomy: a systematic review and meta-analysis.International journal of colorectal disease · 2026Pooled it
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIleocolonic anastomoses are frequent in colorectal surgeries, but anastomotic leakage remains a serious complication associated with increased morbidity and mortality. The optimal peristaltic orientation for anastomosis is still debated.
aimTo evaluate and compare short- and long-term outcomes of isoperistaltic (IA) and antiperistaltic (AA) side-to-side ileocolic anastomoses after right colectomy or ileocecal resection for right-sided adenocarcinoma or Crohn's disease.
methodsA single-center retrospective clinical trial was conducted at Fattouma Bourguiba University Hospital, Monastir, involving patients with right-sided colon cancer or ileocecal Crohn's disease who underwent elective resection with either IA or AA. The primary outcome was anastomotic leakage, while secondary outcomes included postoperative morbidity and long-term results.
resultsNinety-four patients, including 55 with right-sided colon cancer and 39 with Crohn's disease, were analyzed between January 2016 and July 2023. Of these, 48 underwent IA, and 46 underwent AA. Both anastomotic techniques exhibited similar leakage rates. Baseline and operative variables were comparable except for male predominance in AA for Crohn's disease and a higher conversion rate in AA. No significant differences were noted regarding pathological variables, operative time, bowel transit recovery, oral tolerance, hospital stay, or postoperative complications. Multivariate analysis revealed that elevated white blood cell count, R2 resection, and mucinous adenocarcinoma were risk factors for anastomotic leakage, while albumin levels and staple line reinforcement were protective factors against postoperative morbidity.
conclusionIA and AA demonstrated comparable safety and feasibility, though AA had a higher conversion rate. Further studies are required to optimize AA safety.
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