Intracorporeal versus extracorporeal anastomosis in laparoscopic colectomy: comparison of postoperative complications, functional recovery and length of stay – a systematic review

Introduction: In laparoscopic colectomy, the anastomosis may be performed inside the abdominal cavity (intracorporeal, ICA) or after bowel exteriorization (extracorporeal, ECA). Objective: To compare ICA and ECA regarding postoperative complications, functional recovery and length of stay. Methods: Systematic review (PRISMA 2020) in PubMed, SciELO, LILACS and Web of Science, 2016–2026, using DeCS/MeSH descriptors and Boolean operators; qualitative synthesis. Results: Of 804 records, 12 studies were included. ICA was associated with lower overall morbidity, surgical site infection (OR 0.27–0.56) and incisional hernia (OR 0.29), earlier return of bowel function and up to one-day shorter stay, at the cost of longer operative time. Leak and ileus did not differ. Conclusion: ICA offers incision-related and recovery advantages with similar anastomotic safety and is a preferred option for trained teams. (AU)