EP821 - Factors associated with intracorporeal vs. extracorporeal vs. conversion to open ileocolic anastomosis creation in Crohn’s patients undergoing robotic ileocolic resection

ePoster Presenter(s)

• 

  Sophia Y. Chen, MD, MPH

  Colon & Rectal Surgery Fellow
  NYU Langone Health
  NYU Langone Health
  New York, NY, United States

  Disclosure information not submitted.

Author(s)

• AP

  Angelos Papanikolaou, MD

  General Surgery Resident
  NYU Langone
  New York, New York, United States

  Disclosure information not submitted.
• JS

  Jessica N. Simon, MD

  Assistant Professor of Surgery
  NYU Langone Health
  New York, New York, United States

  Disclosure information not submitted.
• 

  chady Atallah, MD, FACS

  Associate Professor
  NYU Langone Hospital
  New York, New York, United States

  Disclosure information not submitted.
• BS

  Bashar A. Safar, MBBS

  Division Chief
  NYU Langone
  new york, New York, United States

  Disclosure information not submitted.
• FR

  Feza H. Remzi, MD, FACS, FTSS (Hon)

  Vice President, Center for Advanced Inflammatory Bowel Disease Care
  Donald and Barbara Zucker School of Medicine, Northwell Health
  Manhasset, New York, United States

  Disclosure information not submitted.
• 

  David Dietz, MD, MHCDS

  Professor and Vice Chair for Value and Clinical Transformation, Department of Surgery
  NYU Grossman School of Medicine
  new york, New York, United States

  Disclosure information not submitted.

Senior Author(s)

• AM

  Andre Moreira, MD, PhD

  Clinical Associate Professor of Surgery
  NYU Grossman School of Medicine
  New York, New York, United States

  Disclosure information not submitted.

Purpose/Background: The purpose of this study is to assess factors associated with the creation of an intracorporeal vs. extracorporeal vs. conversion to open ileocolic anastomosis in Crohn's disease patients undergoing robotic ileocolic resection.

Methods/Interventions: Adult Crohn's disease patients who underwent a robotic ileocolic resection were analyzed retrospectively using a single-surgeon institutional database from September 2022 to September 2025 at a tertiary academic center. The primary outcome was anastomosis creation method (intracorporeal vs. extracorporeal vs. conversion to open). Secondary outcomes were length of stay (LOS), 30-day morbidity, reoperation, readmission, and mortality. Univariate analysis was performed to identify potential factors for each anastomosis creation method.

Results/Outcomes: A total of 71 Crohn's disease patients underwent robotic ileocolic resections; 4 patients were excluded because they did not undergo anastomosis creation. Of the 67 patients who underwent robotic ileocolic resection with anastomosis creation, 28 patients (41.8%) had an intracorporeal anastomosis, 31 (46.3%) an extracorporeal anastomosis, and 8 (11.9%) a conversion to open anastomosis. Patients who had a conversion to open anastomosis tended to be older, have larger BMI, a Remzi grade 3 ileocolic Crohn's disease classification, and a diverting loop ileostomy created at the time of surgery. There was a trend towards longer LOS for patients who underwent an extracorporeal (median LOS 5 days, interquartile range [IQR] 4-7 days) or conversion to open anastomosis (median LOS 6 days, IQR 5-7 days), compared to those who had an intracorporeal anastomosis (median LOS 4, IQR 4-5.5 days). No differences in 30-day morbidity, reoperation, readmission, or mortality were observed. On univariate analysis, older age and higher Remzi ileocolic Crohn's classification grade were associated with decreased odds of intracorporeal anastomosis creation, whereas female sex was associated with increased odds. Higher BMI and albumin was associated with decreased odds of extracorporeal anastomosis creation. Finally, older age, higher BMI, and higher Remzi ileocolic Crohn's classification grade were associated with increased odds of conversion to open anastomosis creation (Table).

Conclusion/Discussion: Patient clinical and Crohn's disease phenotypic features preoperatively and observed at the time of robotic ileocolic resection may determine whether an ileocolic anastomosis can be created intracorporeally, extracorporeally, or require conversion to open. Understanding these potential factors may guide surgeons and patients in the preoperative surgical planning and decision-making process.

TABLE. Univariate Analysis of Crohn's Patients Undergoing Robotic Ileocolic Resection
TABLE. Univariate Analysis of Crohn's Patients Undergoing Robotic Ileocolic Resection