The feasibility and safety of “RISE” ileocolic anastomosis procedure based on functional reconstruction of ileocecal valve for right hemicolectomy: a retrospective cohort study

Background: Conventional right hemicolectomy (CRH) involves the resection of the ileocecal valve (ICV), a critical anatomical structure that regulates the flow between the small and large intestines. Its removal may disrupt the physiological barrier function, leading to postoperative complications such as diarrhea, malabsorption, and retrograde flow of colonic contents, which predispose patients to small intestinal bacterial overgrowth. This study aims to assess the feasibility and safety of a novel functional reconstruction technique – Revolute Insert Side-to-End (RISE) ICV reconstruction – following laparoscopic right hemicolectomy with D2 lymphadenectomy. Methods: We conducted a retrospective cohort analysis of consecutive patients with right-sided colon cancer who underwent laparoscopic right hemicolectomy and D2 lymphadenectomy at our institution between January 2021 and November 2023. Patients were divided into two groups according to the ileocolic anastomotic method: RISE ( n = 17) vs. conventional side-to-side (CSS; n = 26). All postoperative patients underwent Enhanced Recovery After Surgery, resuming oral water intake 4 h after surgery and ambulating on the first postoperative day. Demographics, tumor characteristics, operative details, oncologic parameters, postoperative recovery milestones, and 30-day complication profiles (Clavien–Dindo classification) were collected and compared. Results: Seventeen patients received RISE anastomosis, and 26 underwent CSS anastomosis. Mean operative time did not differ significantly between the RISE and CSS groups (237.24 ± 53.71 vs. 219.42 ± 51.48 min; P = 0.47). Estimated blood loss was comparable. The RISE cohort experienced a significantly earlier return of gastrointestinal function, including time to first flatus (median 2 vs. 3 days) and the first passage of formed stool (Bristol Scale type ≤4) (all P < 0.001). The median number of harvested lymph nodes was similar [RISE: 20 (15–27.5) vs. CSS: 18 (14–23.5); P = 0.29]. Rates of minor morbidity (Clavien–Dindo I–II) did not differ significantly between the groups (RISE: 5.9% vs. CSS: 11.5%; P = 0.93). Conclusion: RISE anastomosis, which restores ICV function after laparoscopic right hemicolectomy, is both safe and technically feasible. It confers accelerated postoperative bowel recovery, with no significant increase in complications observed in this study.