We routinely performed mechanical bowel preparation 1 day before surgery regardless of anastomotic technique. In the ECA group, the mobilized bowel was extracted through a commercial wound protector following a further incision that continued through the previous periumbilical incision (Fig. 1A). An ECA was performed in an end-to-side manner using a circular stapler, side-to-side using a linear stapler or end-to-end with hand-sewn technique. In the ICA group, the transverse mesocolon and small bowel mesentery were divided using a surgical energy device. Subsequently, the transverse colon and terminal ileum were transected using laparoscopic staplers (Fig. 1B). We placed gauze under the anastomotic site to minimize the spread of bowel content into the abdominal cavity during the ICA. Enterotomy and colostomy were performed, and a linear stapler was used to create an isoperistaltic, side-to-side anastomosis. After stapling for anastomosis, sufficient irrigation and suction were performed. The stapler insertion site was closed with continuous stitches using V-Loc sutures (Covidien). The specimen was extracted through a periumbilical or Pfannenstiel incision.