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The optimal extent of colectomy for splenic flexure carcinoma - Extended vs segmental? Less is best!

Published:November 14, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.10.054
      The debate regarding the optimal operation for splenic flexure carcinoma (SFC)

      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).

      has been stifled historically by low quality studies with small patient populations because SFC represents only 8% of colon cancers.
      • Levien D.H.
      • Gibbons S.
      • Begos D.
      • Byrne D.W.
      Survival after resection of carcinoma of the splenic flexure.
      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).
      • Vasey C.E.
      • Rajaratnam S.
      • O'Grady G.
      • Hulme-Moir M.
      Lymphatic drainage of the splenic flexure defined by intraoperative scintigraphic mapping.
      Therefore, as an oncologic operation for SFC, segmental colectomy provides adequate lymphatic clearance and lymph node (LN) harvest.
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      References

      1. 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).

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