SRS156 - Improved post-operative outcomes in intracorporeal anastomosis in elective right hemicolectomy

Abstract Aim/Objectives The optimal technique for anastomosis after laparoscopic and robotic right hemicolectomy remains debated. Both intracorporeal anastomosis (ICA) and extracorporeal anastomosis (ECA) may influence short-term recovery, complications, and oncological adequacy. We aimed to compare ICA versus ECA outcomes in a single-surgeon series, focusing on post-operative recovery, morbidity, and histopathological quality. Methods Thirty-four consecutive elective right hemicolectomies performed between February 2020, and September 2025 were identified from a prospectively maintained database. They were grouped by anastomotic technique (ICA versus ECA), reflecting a transition in practice over time. Data collected included demographics, operative approach, length of stay (LOS), complications (graded by Clavien-Dindo), re-admissions, lymph node harvest, and margin status. Statistics were performed using SPSS v27. Results 17 patients had ICA and 17 had ECA. 56% were Female. Median age in years for ICA cohort: 70 (36–83), and for ECA cohort: 76 (48–94). Surgical approach: Laparoscopic (n = 31), and Robotic (n = 3). ICA was associated with a shorter median LOS compared with ECA (3 versus 4.5 days, P = 0.040). Re-admissions occurred in two ECA patients (bowel-obstruction, post-op gastritis) and one ICA patient (intra-abdominal collection), all managed conservatively. Clavien-Dindo II complications in two ECA patients, no other higher complications. No anastomotic leaks were observed. Median lymph node yield was 21 in both groups, with all resections achieving R0 margins. Conclusions This single-surgeon series demonstrates safe implementation of ICA with a shorter LOS and excellent oncological quality, reflecting progressive refinement of minimally invasive right hemicolectomy and improved peri-operative care.