December 4, 2025Open Access

Comparison of surgical complications, mortality, and pathological findings based on anastomosis choice after emergency right hemicolectomy

HBHakan BaydarIstanbul Metropolitan Municipality MDMurat DemirEskişehir City Hospital İKİdris KurtuluşEskişehir City Hospital

Key Points

Mortality rate of 5.6% observed without significant differences among anastomosis techniques used.
An overall anastomotic leakage rate of 6.3% was recorded across all methods employed.
Retrospective observational analysis evaluated outcomes in 143 adult patients who underwent emergency surgery.
Surgeons advised to choose familiar anastomosis techniques to optimize operative efficiency in high-pressure settings.

Abstract

Emergency right hemicolectomy is a surgical intervention performed in life-threatening conditions such as colonic obstruction, ischemia, perforation, or massive hemorrhage, and it carries a high risk of morbidity and mortality. To restore the continuity of the gastrointestinal tract after surgery, various anastomosis techniques are employed. However, the clinical outcomes of these techniques under emergency conditions remain unclear. This study aims to compare the effects of different anastomosis methods used in open surgery on postoperative complications, mortality, pathological compatibility, and length of hospital stay. This retrospective, single-center observational study included 143 adult patients who underwent emergency open right hemicolectomy between January 1, 2021, and August 31, 2024. Patients were divided into 3 groups based on the anastomosis technique used: hand-sewn, linear stapler, and circular stapler anastomosis. Demographic data, surgical indications, postoperative complications according to the Clavien-Dindo classification, 1 month follow-up outcomes, pathological concordance, and length of hospital stay were evaluated. Of the patients, 60.1% were male, and the mean age was 56.79 ± 18.04 years. Linear stapler (48.3%), hand-sewn (28%), and circular stapler (23.7%) techniques were used. The overall anastomotic leakage rate was 6.3%, with no statistically significant difference among the techniques ( P > .05). The mortality rate was 5.6%, and the malignancy rate was 71.3%. No significant association was found between the type of anastomosis and postoperative complications, mortality, or length of hospital stay. The choice of anastomosis technique in emergency open right hemicolectomy does not significantly affect morbidity or mortality. The optimal approach is for the surgeon to employ the technique with which they have the greatest experience. Due to the potential to reduce operative time, the use of staplers is recommended in high-volume centers.

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