The debate regarding the optimal operation for splenic flexure carcinoma (SFC)
1
has been stifled historically by low quality studies with small patient populations
because SFC represents only 8% of colon cancers.
2
Intraoperative scintigraphic mapping in subjects with normal splenic flexures revealed
that lymphatics preferentially drain towards the left colic artery 96–97% of the time
(rather than to left-sided branches of the middle colic artery).
3
Therefore, as an oncologic operation for SFC, segmental colectomy provides adequate
lymphatic clearance and lymph node (LN) harvest.To read this article in full you will need to make a payment
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References
Ozgur I, Liska D, Valente MA, et al. Best surgical approach for splenic flexure colon cancers: extended versus segmental resection? Am J Surg 2023; 225(3).
- Survival after resection of carcinoma of the splenic flexure.Dis Colon Rectum. 1991; 34: 401-403
- Lymphatic drainage of the splenic flexure defined by intraoperative scintigraphic mapping.Dis Colon Rectum. 2018; 61: 441-446
- Surgical treatment and subsequent outcome of patients with carcinoma of the splenic flexure.Surg Today. 2001; 31: 204-209
- What is the optimal elective colectomy for splenic flexure cancer: end of the debate? A multicenter study from the GRECCAR Group with a propensity score analysis.Dis Colon Rectum. 2022; 65: 55-65
- Segmental vs. extended colectomy: measurable differences in morbidity, function and quality of life.Dis Colon Rectum. 2008; 51: 1036-1043
- The Will Rogers phenomenon: stage migration and new diagnostic techniques as a source of misleading statistics for survival in cancer.NEJM. 1985 Jun 20; 312: 1604-1608
Article info
Publication history
Published online: November 14, 2022
Accepted:
October 25,
2022
Received:
October 24,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.