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Best surgical approach for splenic flexure colon cancers: Extended versus segmental resection?

Published:November 15, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.014

      Highlights

      • Surgical treatment of splenic flexure colon cancer remains controversial regarding extent of colon resection.
      • Dual lymphatic drainage in splenic flexure enquiries optimal extent of surgical resection and mesenteric vascular ligation.
      • The overall and disease free survival were similar for extended and segmental colonic resection groups.

      Abstract

      Background

      The optimal surgical treatment approach for splenic flexure colon cancers remains controversial regarding the type of resection.

      Methods

      We hypothesized that both extended and segmental resections have similar surgical and oncologic outcomes. A retrospective review of prospectively collected database was performed on all patients who had colectomy for splenic flexure colon cancer between 1996 and 2018.

      Results

      Of 142 patients, 119 underwent extended resection; therefore, this group was compared with the group which underwent segmental resection (n = 23). The groups were similar in age, sex, ASA scores, operative times, estimated blood loss, hospital length of stay, and postoperative complication rates (p > 0.05). Median follow-up was 9.58 years (IQR:5.46–16.48). Multivariable regression models demonstrated no significant association between resection approach and disease-free survival (HR 1.63 [95%CI:0.91–2.92]), as well as overall survival (HR 1.80 [95%CI:0.97; 3.36]).

      Conclusion

      In the treatment of splenic flexure colon cancer, segmental colon resections have similar oncologic outcomes when compared to extended colectomies.

      Keywords

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