{
  "abstract": "BACKGROUND:: Intracorporeal anastomosis benefits are often offset by high costs and technical complexity.\n\nOBJECTIVE:: To evaluate the safety, efficacy, and cost-neutrality of a novel U-tied functional end-to-end anastomosis versus conventional laparoscopic-assisted colectomy.\n\nDESIGN:: Prospective cohort study following the Idea, Development, Exploration, Assessment, Long-term follow-up stage 2b framework using inverse probability of treatment weighting.\n\nSETTINGS:: Single tertiary referral hospital.\n\nPATIENTS:: Patients undergoing elective radical colectomy for colon cancer (May 2023 to December 2025).\n\nINTERVENTIONS:: Intracorporeal U-tied functional end-to-end anastomosis versus conventional extracorporeal anastomosis.\n\nMAIN OUTCOME MEASURES:: Overall 30-day postoperative complications, operative metrics, recovery indicators, postoperative pain, and hospital costs.\n\nRESULTS:: Of 461 patients, 294 underwent extracorporeal and 167 received U-tied anastomosis. After weighting, baseline covariates were balanced. Thirty-day complication rates were comparable between U-tied and conventional groups (10.8% vs 11.3%; p = 0.907), a finding consistently supported by sensitivity analyses (all p > 0.05). However, this nonsignificant result should be interpreted cautiously as an absence of evidence to detect a difference. Although the U-tied group required longer anastomosis time (27.4 vs 22.4 minutes; p < 0.001), total operative times were comparable (p = 0.172). The U-tied group showed significant advantages in shorter incisions (4.3 vs 8.9 cm), reduced blood loss, and earlier return of bowel function (flatus: 60.8 vs 80.4 hours; defecation: 73.9 vs 87.0 hours; all p < 0.001). Visual analog scale scores were significantly lower in the U-tied group on postoperative day 1 (p < 0.001).\n\nLIMITATIONS:: Single-center design and limited statistical power for rare complications.\n\nCONCLUSIONS:: The U-tied functional end-to-end anastomosis is a safe, feasible, and cost-neutral intracorporeal technique that reduces surgical trauma, alleviates early pain, and accelerates recovery. See Video Abstract.\n\nCOMPARACIÓN DE UNA NUEVA ANASTOMOSIS INTRACORPÓREA FRENTE A UNA ANASTOMOSIS EXTRACORPÓREA PARA EL CÁNCER DE COLON: UN ESTUDIO DE COHORTE PROSPECTIVO PONDERADO POR PUNTUACIÓN DE PROPENSIÓN SOBRE IDEA, DESARROLLO, EXPLORACIÓN, EVALUACIÓN Y SEGUIMIENTO A LARGO PLAZO EN ESTADIO 2B: ANTECEDENTES:\n\nLos beneficios de la anastomosis intracorpórea suelen verse contrarrestados por los altos costos y la complejidad técnica.\n\nOBJETIVO:\n\nEvaluar la seguridad, la eficacia y la neutralidad de costos de una nueva anastomosis funcional término-terminal con ligadura en U frente a la colectomía laparoscópica convencional.\n\nDISEÑO:\n\nEstudio de cohorte prospectivo siguiendo el marco de la Etapa 2b de Idea, Desarrollo, Exploración, Evaluación y Seguimiento a Largo Plazo, utilizando ponderación por probabilidad inversa del tratamiento.\n\nÁMBITO:\n\nUn único hospital de referencia terciaria.\n\nPACIENTES:\n\nPacientes sometidos a colectomía radical electiva por cáncer de colon (de mayo de 2023 a diciembre de 2025).\n\nINTERVENCIONES:\n\nAnastomosis funcional término-terminal intracorpórea con ligadura en U frente a anastomosis extracorpórea convencional.\n\nPRINCIPALES MEDIDAS DE RESULTADO:\n\nComplicaciones postoperatorias generales a los 30 días, parámetros quirúrgicos, indicadores de recuperación, dolor postoperatorio y costos hospitalarios.\n\nRESULTADOS:\n\nDe 461 pacientes, 294 se sometieron a anastomosis extracorpórea y 167 recibieron anastomosis en U. Tras la ponderación, las covariables basales se equilibraron. Las tasas de complicaciones a los 30 días fueron comparables entre los grupos de anastomosis en U y convencional (10,8 % frente a 11,3 %, p = 0,907), un hallazgo respaldado consistentemente por los análisis de sensibilidad (todos los p > 0,05). Sin embargo, este resultado no significativo debe interpretarse con cautela, ya que no hay evidencia para detectar una diferencia. Aunque la anastomosis en U requirió un tiempo de anastomosis más prolongado (27,4 frente a 22,4 min, p < 0,001), los tiempos quirúrgicos totales fueron comparables (p = 0,172). El grupo con anastomosis en U mostró ventajas significativas en cuanto a incisiones más cortas (4,3 cm frente a 8,9 cm), menor pérdida de sangre y recuperación más temprana de la función intestinal (flatulencia: 60,8 horas frente a 80,4 horas; defecación: 73,9 horas frente a 87,0 horas; p < 0,001 en todos los casos). Las puntuaciones de la escala analógica visual (EAV) fueron significativamente menores en el grupo con anastomosis en U en el Pod 1 (p < 0,001). Limitaciones: Diseño unicéntrico y potencia estadística limitada para complicaciones poco frecuentes.\n\nCONCLUSIONES:\n\nLa anastomosis funcional término-terminal con anastomosis en U es una técnica intracorpórea segura, factible y económicamente neutra que reduce el trauma quirúrgico, alivia el dolor precoz y acelera la recuperación. (AI-generated translation)",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Surgery, Division of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China",
    "Department of Kidney Transplantation, Hospital of Nephropathy, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China",
    "Institute of Digestive Surgery, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Qiang Du"
    },
    {
      "affs": [
        1
      ],
      "name": "Tian Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Libin Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Chen"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Lie Yang",
      "orcid": "0000-0003-1178-7147"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Zongguang Zhou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/620q54e26cgqk.bib",
  "cited_by": 0,
  "doi": "10.1097/dcr.0000000000004386",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13727028/",
  "id": "620q54e26cgqk",
  "issns": [
    "0012-3706",
    "1530-0358"
  ],
  "landing_url": "https://doi.org/10.1097/dcr.0000000000004386",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Contributions"
    ],
    [
      "heading",
      "Outcomes"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Surgical Treatments"
    ]
  ],
  "openalex": "W7203832829",
  "pdf_url": null,
  "pmcid": "PMC13727028",
  "pmid": "42621732",
  "published": "2026-08-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/620q54e26cgqk.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:23:14Z",
      "native_id": "PMC13727028",
      "source": "pmc",
      "url": "https://doi.org/10.1097/dcr.0000000000004386"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Surgical Treatments",
      "subfield": "oncology"
    }
  ],
  "title": "Comparison of a Novel Intracorporeal Anastomosis Versus Extracorporeal Anastomosis for Colon Cancer: A Propensity Score–Weighted, Prospective Idea, Development, Exploration, Assessment, Long-term Stage 2b Cohort Study",
  "title_text": "Comparison of a Novel Intracorporeal Anastomosis Versus Extracorporeal Anastomosis for Colon Cancer: A Propensity Score–Weighted, Prospective Idea, Development, Exploration, Assessment, Long-term Stage 2b Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:50Z",
  "url": "https://research.draconitic.com/paper/620q54e26cgqk",
  "venue": "Diseases of the Colon and Rectum",
  "versions": []
}