Perioperative and functional outcomes of the deloyers procedure compared to other reconstructive options after extended left or subtotal colectomy: a systematic review.

Document Type

Article

Publication Date

9-30-2026

Abstract

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.

Comments

This article was published in Surgical Endoscopy.

The published version is available at https://doi.org/10.1007/s00464-026-13355-7.

Copyright © 2026 The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.

Publication Title

Surgical Endoscopy

PubMed ID

42816637

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