Surgical endoscopy · 2026
Perioperative and functional outcomes of the deloyers procedure compared to other reconstructive options after extended left or subtotal colectomy: a systematic review.
СтатьяНазвание и аннотация: Перевод в очереди
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Karakozis Lampros, Abdelmasseh Michael, Gerges Michael, Aquina Christopher T, Soliman Mark
Аннотация
BACKGROUND: After major left-sided colonic resections, achieving a tension-free anastomosis while preserving bowel continuity can be technically demanding, historically leading many surgeons to choose a permanent ostomy. The Deloyers procedure offers a reconstructive alternative that avoids a permanent stoma and preserves the right colon's absorptive function.
OBJECTIVE: To evaluate perioperative and functional outcomes of the Deloyers procedure compared to other reconstructive options, following extended left or subtotal colectomy, informing surgical planning for bowel continuity restoration.
MATERIALS AND METHODS: Of the 220 studies initially identified, 18 comprising 283 cases met the inclusion criteria. A systematic review was conducted following PRISMA 2020 guidelines. Patient demographics and outcomes were independently extracted from the studies by 3 researchers, compared, and discussed to a consensus. Risk of bias and the quality of the methodology were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools.
RESULTS: Our systematic review yielded 283 patients overall from the 18 studies. Thirteen reported outcomes of the Deloyers procedure only, while 5 reported comparative outcomes of the Deloyers procedure to other anastomotic techniques, such as ileorectal anastomosis (2, 17), trans-mesenteric anastomosis (8, 10), and complete intestinal rotation (11). Most studies were from Europe and Asia. Most procedures were open (82%); the most common indication was colon cancer (39%). Reported late complications included surgical site infection (n=10, 3.5%), post-operative ileus (n=13, 4.6%), anastomotic leak (n=10, 3.5%), anastomotic stricture/stenosis (n=9, 3.2%), and incisional hernia (n=11, 3.9%). Long-term functional outcomes were reported in 14 of 18 studies (78%), with a consistent median of 2-3 daily bowel movements at final follow-up. Follow-up ranged from 6 to 120 months.
CONCLUSION: The Deloyers procedure is a valuable and safe option for re-establishing bowel continuity after major colonic resections, with outcomes comparable to those of other types of anastomoses.
OBJECTIVE: To evaluate perioperative and functional outcomes of the Deloyers procedure compared to other reconstructive options, following extended left or subtotal colectomy, informing surgical planning for bowel continuity restoration.
MATERIALS AND METHODS: Of the 220 studies initially identified, 18 comprising 283 cases met the inclusion criteria. A systematic review was conducted following PRISMA 2020 guidelines. Patient demographics and outcomes were independently extracted from the studies by 3 researchers, compared, and discussed to a consensus. Risk of bias and the quality of the methodology were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools.
RESULTS: Our systematic review yielded 283 patients overall from the 18 studies. Thirteen reported outcomes of the Deloyers procedure only, while 5 reported comparative outcomes of the Deloyers procedure to other anastomotic techniques, such as ileorectal anastomosis (2, 17), trans-mesenteric anastomosis (8, 10), and complete intestinal rotation (11). Most studies were from Europe and Asia. Most procedures were open (82%); the most common indication was colon cancer (39%). Reported late complications included surgical site infection (n=10, 3.5%), post-operative ileus (n=13, 4.6%), anastomotic leak (n=10, 3.5%), anastomotic stricture/stenosis (n=9, 3.2%), and incisional hernia (n=11, 3.9%). Long-term functional outcomes were reported in 14 of 18 studies (78%), with a consistent median of 2-3 daily bowel movements at final follow-up. Follow-up ranged from 6 to 120 months.
CONCLUSION: The Deloyers procedure is a valuable and safe option for re-establishing bowel continuity after major colonic resections, with outcomes comparable to those of other types of anastomoses.