Relationship between anastomotic technique, incisional hernia, and quality of life—the Minimally Invasive Right Colectomy Anastomosis STudy (MIRCAST) - Scorecard - MDSpire

Relationship between anastomotic technique, incisional hernia, and quality of life—the Minimally Invasive Right Colectomy Anastomosis STudy (MIRCAST)

  • By

  • Marcos Gómez Ruiz

  • On behalf of

  • MIRCAST study group (collaborative)

  • Juan García Cardo

  • Marcos Gómez Ruiz

  • Eloy Espin Basany

  • Mindaugas Tiskus

  • Ugo Pace

  • Tarja Pinta

  • Paolo Pietro Bianchi

  • Andrea Coratti

  • Roberto Persiani

  • Roberto Coppola

  • Nuria Truan Alonso

  • Franco Marinello

  • Miquel Kraft Carre

  • Mirjana Komljen

  • Shadi Andos

  • Paolo Delrio

  • Daniela Rega

  • Giuseppe Giuliani

  • Lucia Salvischiani

  • Alberto Biondi

  • Laura Lorenzon

  • Damiano Caputo

  • Vincenzo La Vaccara

  • Daniel Fernández Martinez

  • Carmen Cagigas Fernández

  • Lidia Cristobal Poch

  • Gina Lladó-Jordan

  • Camilo Palazuelos Calderón

  • Lucía Lavín Alconero

  • Vincenzo Vigorita

  • Raquel Sánchez Santos

  • Paula Fernández Rodriguez

  • Fernando Jimenez Escobar

  • Tamara Fernández Miguel

  • Vicente Portugal Porras

  • Alejandro Romero de Diego

  • Maria Ruíz Soriano

  • Beatriz de Andrés Asenjo

  • Dursun Bugra

  • Emre Balik

  • Emre Özoran

  • Andrea Muratore

  • Marcello Calabrò

  • Antonio La Terra

  • Ángel Reina Duarte

  • Pälvi Vento

  • Inna Lupina

  • David Moro-Valdezate

  • José Martín-Arévalo

  • Juan Ocaña Jiménez

  • Araceli Ballestero—Pérez

  • Ellen Van Eetvelde

  • Daniel Jacobs-Tulleneers-Thevissen

  • Irshad Shaikh

  • Dolly Dowsett

  • Esther Kreisler Moreno

  • Ana Gálvez Saldaña

  • Antonino Spinelli

  • Francesca Di Candido

  • Luis Miguel Jimenez Gomez

  • Elena Hurtado Caballero

  • Andreas Türler

  • Anna Krappitz

  • Luca Morelli

  • Annalisa Comandatore

  • Matteo Palmeri

  • Vicente Simó

  • Jorge Arredondo Chaves

  • Benno Mann

  • Gintautas Virakas

  • Jim Khan

  • Ismail Gögenur

  • Niclas Dohrn

  • Eduardo Ferrero Herrero

  • Eduardo Rubio González

  • Javier Sanchez Gonzalez

  • Ekta Choolani Bhojwani

  • Francesk Mulita

  • Vasileios Leivaditis

  • Goran Šantak

  • Matteo Frasson

  • Marta Nieto

  • Jakob Lykke

  • Niclas Dohrn

  • Mauro Garino

  • Chiara Marafante

  • Antonio Arroyo

  • Cristina Lillo-García

  • Carlos Placer Galan

  • José María Enriquez Navascués

  • Wanda Luisa Petz

  • Simona Borin

  • Philippe Rouanet

  • Christophe Taoum

  • Alain Valverde

  • Markus Winny

  • Çağrı Büyükkasap

  • Benoit Romain

  • Orestis Ioannidis

  • Giuseppe Spinoglio

  • David Jayne

  • Roger Gerjy

  • Sanjay Chaudhri

  • Luis Sánchez-Guillén

  • Alexis Ulrich

  • Tero Rautio

  • Jesus Bollo Rodriguez

  • Nuno Rama

  • Federico Perna

  • Eric Rullier

  • Fernando Mendoza

  • Thalia Petropoulou

  • Arto Turunen

  • Mauricio García Alonso

  • Anne Mattila

  • Julian Hance

  • Bertrand Trilling

  • Imma Prós Ribas

  • Adeline Germain

  • Kai Leong

  • December 8, 2025

  • 0 min

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Clinical Scorecard: Impact of Anastomotic Methods on Incisional Hernia Development and Quality of Life: Insights from the Minimally Invasive Right Colectomy Anastomosis Study (MIRCAST)

At a Glance

CategoryDetail
ConditionRight colon cancer requiring minimally invasive right colectomy
Key MechanismsComparison of intracorporeal anastomosis (ICA) versus extracorporeal anastomosis (ECA) techniques affecting postoperative complications, incisional hernia rates, and quality of life
Target PopulationAdult patients (≥18 years) undergoing elective minimally invasive right colectomy for right colon tumors
Care SettingHigh-volume European surgical centers with experienced colorectal surgeons performing minimally invasive procedures

Key Highlights

  • ICA is associated with faster bowel recovery, fewer postoperative complications, and lower incisional hernia rates compared to ECA.
  • Pfannenstiel incision used in ICA for specimen extraction is protective against incisional hernia formation compared to midline incisions used in ECA.
  • Postoperative complications negatively impact quality of life; MIRCAST is the first multicenter prospective study assessing QoL specifically after minimally invasive right colectomy and anastomotic technique.

Guideline-Based Recommendations

Diagnosis

  • Patient selection includes adults with right colon tumors suitable for elective minimally invasive right colectomy with curative intent.
  • Exclude patients with cT4b tumors, metastatic disease, inflammatory bowel disease, or requiring emergency surgery.

Management

  • Perform minimally invasive right colectomy using either ICA or ECA based on surgeon expertise and patient factors.
  • Prefer ICA with Pfannenstiel incision for specimen extraction to reduce incisional hernia risk.
  • Implement enhanced recovery after surgery (ERAS) protocols where available.

Monitoring & Follow-up

  • Prospective follow-up at 30 days, 90 days, 1 year, and 2 years postoperatively to assess complications, incisional hernia development, oncological outcomes, and quality of life.
  • Use validated QoL instruments such as EQ-5D and EORTC QLQ-C30 and CR29 modules.

Risks

  • Higher incisional hernia rates associated with ECA and midline incisions.
  • Postoperative complications adversely affect long-term quality of life.

Patient & Prescribing Data

Adults undergoing minimally invasive right colectomy for right colon tumors in European high-volume centers

ICA technique demonstrates improved postoperative recovery and reduced incisional hernia rates, potentially leading to better quality of life outcomes compared to ECA.

Clinical Best Practices

  • Select anastomotic technique (ICA vs ECA) based on surgeon experience and patient characteristics.
  • Utilize Pfannenstiel incision for specimen extraction in ICA to minimize incisional hernia risk.
  • Adopt ERAS protocols to enhance postoperative recovery.
  • Conduct thorough prospective monitoring including QoL assessments to guide patient-centered care.

References

Original Source(s)

Relationship between anastomotic technique, incisional hernia, and quality of life—the Minimally Invasive Right Colectomy Anastomosis STudy (MIRCAST)

  • by Marcos Gómez Ruiz, On behalf of, MIRCAST study group (collaborative), Juan García Cardo, Marcos Gómez Ruiz, Eloy Espin Basany, Mindaugas Tiskus, Ugo Pace, Tarja Pinta, Paolo Pietro Bianchi, Andrea Coratti, Roberto Persiani, Roberto Coppola, Nuria Truan Alonso, Franco Marinello, Miquel Kraft Carre, Mirjana Komljen, Shadi Andos, Paolo Delrio, Daniela Rega, Giuseppe Giuliani, Lucia Salvischiani, Alberto Biondi, Laura Lorenzon, Damiano Caputo, Vincenzo La Vaccara, Daniel Fernández Martinez, Carmen Cagigas Fernández, Lidia Cristobal Poch, Gina Lladó-Jordan, Camilo Palazuelos Calderón, Lucía Lavín Alconero, Vincenzo Vigorita, Raquel Sánchez Santos, Paula Fernández Rodriguez, Fernando Jimenez Escobar, Tamara Fernández Miguel, Vicente Portugal Porras, Alejandro Romero de Diego, Maria Ruíz Soriano, Beatriz de Andrés Asenjo, Dursun Bugra, Emre Balik, Emre Özoran, Andrea Muratore, Marcello Calabrò, Antonio La Terra, Ángel Reina Duarte, Pälvi Vento, Inna Lupina, David Moro-Valdezate, José Martín-Arévalo, Juan Ocaña Jiménez, Araceli Ballestero—Pérez, Ellen Van Eetvelde, Daniel Jacobs-Tulleneers-Thevissen, Irshad Shaikh, Dolly Dowsett, Esther Kreisler Moreno, Ana Gálvez Saldaña, Antonino Spinelli, Francesca Di Candido, Luis Miguel Jimenez Gomez, Elena Hurtado Caballero, Andreas Türler, Anna Krappitz, Luca Morelli, Annalisa Comandatore, Matteo Palmeri, Vicente Simó, Jorge Arredondo Chaves, Benno Mann, Gintautas Virakas, Jim Khan, Ismail Gögenur, Niclas Dohrn, Eduardo Ferrero Herrero, Eduardo Rubio González, Javier Sanchez Gonzalez, Ekta Choolani Bhojwani, Francesk Mulita, Vasileios Leivaditis, Goran Šantak, Matteo Frasson, Marta Nieto, Jakob Lykke, Niclas Dohrn, Mauro Garino, Chiara Marafante, Antonio Arroyo, Cristina Lillo-García, Carlos Placer Galan, José María Enriquez Navascués, Wanda Luisa Petz, Simona Borin, Philippe Rouanet, Christophe Taoum, Alain Valverde, Markus Winny, Çağrı Büyükkasap, Benoit Romain, Orestis Ioannidis, Giuseppe Spinoglio, David Jayne, Roger Gerjy, Sanjay Chaudhri, Luis Sánchez-Guillén, Alexis Ulrich, Tero Rautio, Jesus Bollo Rodriguez, Nuno Rama, Federico Perna, Eric Rullier, Fernando Mendoza, Thalia Petropoulou, Arto Turunen, Mauricio García Alonso, Anne Mattila, Julian Hance, Bertrand Trilling, Imma Prós Ribas, Adeline Germain, Kai Leong

  • December 8, 2025

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