Quality of life and functional outcomes of anticlockwise right colon transposition procedure after extended left colectomies

Objective: This work aimed to compare the postoperative quality of life and functional results after an anticlockwise right colon inversion procedure as a salvage technique for colorectal anastomosis after extended left hemicolectomy with the results of total colectomy and ileorectal anastomosis. Patients and Methods: This study was conducted as a prospective case–control study in Alexandria University Hospital between May 2021 and January 2023A total of 40 patients were operated on with extended left hemicolectomies for different indications, and the transverse colon could not reach the rectum in the usual clockwise direction and so the bowel integrity had been regained either by colorectal anastomosis using right colon transposition procedure as a salvage technique for colorectal anastomosis (group A) or with ileorectal anastomosis after total colectomy(group B). Postoperative quality of life and functional results were assessed during the follow-up. Results: Group A consisted of 10 (50%) males and 10 (50%) females while group B consisted of 12 (60%) males and eight (40%) females, with a mean age of 53.40 years (range, 21–75 years) in group A and 52.20 years (range, 25.0–73.0 years) in group B. Assessment of the continence using the Wexner score was done on discharge and 12 weeks after the surgery, and it was found that continence was statistically better in patients of group A when assessed on discharge and the mean Wexner score was 1.30 (range, 0.0–4.0) while in group B the mean Wexner score was 4.75 (range, 2.0–8.0). Conclusion: The right colonic transposition is a safe alternative procedure allowing a tension-free colorectal anastomosis instead of total colectomy and ileorectal anastomosis as it offers a better quality of life and better functional outcome through preservation of the ileocecal valve.