Results of surgical treatment of right-sided colon cancer using intracorporeal anastomoses during the COVID-19 pandemic. (Retrospective cohort study)

Objective. To compare the short-term outcomes of laparoscopic right colectomy during the pre-pandemic, pandemic, and post-pandemic periods, in the context of a transition to the intracorporeal anastomotic technique, and to assess whether this transition was associated with a change in complication rates. Material and methods. This retrospective single-center study included 701 patients who underwent laparoscopic right colectomy between June 2018 and December 2023 (pre-pandemic: n=191, pandemic: n=334, post-pandemic: n=176). The key technical factor analyzed was the anastomotic technique: extracorporeal (n=52) versus intracorporeal (n=649). During the pandemic, the proportion of intracorporeal anastomoses increased from 79.6% to 97.3% (p=0.001), allowing an assessment of its impact on perioperative outcomes under pandemic-related constraints. Results. During the pandemic period, with widespread adoption of the intracorporeal technique, we observed a decrease in overall postoperative complications from 28.3% (pre-pandemic) to 18.6% (pandemic) and 20.5% (post-pandemic) (p=0.019), as well as a decrease in severe complications (Clavien—Dindo ≥3) from 11.5% to 6.3% and 5.1%, respectively (p=0.048). Anastomotic leak rate showed a clear downward trend: 3.1% → 1.8% → 0.6% (p=0.187), coinciding with the predominance of the intracorporeal technique. Operative time and mean length of hospital stay were also significantly shorter in the pandemic and post-pandemic periods (p=0.002 for both). Importantly, among patients with confirmed postoperative SARS-CoV-2 infection (n=13), mortality reached 15.4% (2/13) versus 1.46% in the control group (p=0.006), highlighting persistent risks not mitigated by technical factors alone. Conclusion. During the COVID-19 pandemic, our centre transitioned to intracorporeal anastomotic formation in laparoscopic right colectomy. In the pandemic and post-pandemic periods, lower rates of overall and major complications were observed, along with a trend toward a reduced anastomotic leak rate compared with the pre-pandemic period. These findings suggest that the intracorporeal anastomosis may be a safe and effective technique in the context of crisis-driven reorganisation of hospital services. Prospective comparative studies are needed to confirm a causal relationship.