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Colonic splenic flexure carcinoma: is laparoscopic segmental resection a safe enough oncological approach?

Abstract

BACKGROUND

The surgical approach to the colonic splenic flexure cancer (SFC) is yet to be technically standardized. The aim of this study has been to retrospectively evaluate the oncologic long-term results of our cases comparing our data with other authors' experiences.

METHODS

Clinical data of patients with SFC operated on at our institute were retrospectively analyzed. The laparoscopic approach was used in the whole series, with limited resection distally and proximally to splenic flexure and the origin ligation of left colic artery and left branch of middle colic artery. Data on the oncological long-term safety were compared to our laparoscopic series of extended right colectomy for proximal two-third transverse colon cancer and high anterior resections for sigmoid-high rectal cancer and to the main evidences in the literature, found after a comprehensive review.

RESULTS

From March 2008 to May 2018, we completed 53 laparoscopic splenic flexure resections (26 female and 27 male, age 71.5 ± 15.4 years). The conversion rate was 3.8%. Most of the cases were stage II (pT3 73.5%, the mean number of lymph nodes harvested was 19.1, with positivity for malignancy in 45.3%). During the FU (43.5 months), 2 patients dropped out. Out of the 51 residual cases, 37 were alive (72.5%) and 14 are deceased (27.5%).

DISCUSSION

Compared to the literature, our survival rate does not show significant differences. The other oncological outcomes seem to be comparable with the data evaluated.

CONCLUSIONS

More extended resections seem not to confer an increase of the overall survival rate.

Authors+Show Affiliations

Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy. massimiliano.ardu@gmail.com.Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.Emergency Surgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla 3, 50134, Florence, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31617095

Citation

Ardu, Massimiliano, et al. "Colonic Splenic Flexure Carcinoma: Is Laparoscopic Segmental Resection a Safe Enough Oncological Approach?" Surgical Endoscopy, 2019.
Ardu M, Bergamini C, Martellucci J, et al. Colonic splenic flexure carcinoma: is laparoscopic segmental resection a safe enough oncological approach? Surg Endosc. 2019.
Ardu, M., Bergamini, C., Martellucci, J., Prosperi, P., & Valeri, A. (2019). Colonic splenic flexure carcinoma: is laparoscopic segmental resection a safe enough oncological approach? Surgical Endoscopy, doi:10.1007/s00464-019-07221-y.
Ardu M, et al. Colonic Splenic Flexure Carcinoma: Is Laparoscopic Segmental Resection a Safe Enough Oncological Approach. Surg Endosc. 2019 Oct 15; PubMed PMID: 31617095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colonic splenic flexure carcinoma: is laparoscopic segmental resection a safe enough oncological approach? AU - Ardu,Massimiliano, AU - Bergamini,Carlo, AU - Martellucci,Jacopo, AU - Prosperi,Paolo, AU - Valeri,Andrea, Y1 - 2019/10/15/ PY - 2019/05/16/received PY - 2019/10/09/accepted PY - 2019/10/17/entrez KW - Colon cancer KW - Laparoscopy KW - Splenic flexure JF - Surgical endoscopy JO - Surg Endosc N2 - BACKGROUND: The surgical approach to the colonic splenic flexure cancer (SFC) is yet to be technically standardized. The aim of this study has been to retrospectively evaluate the oncologic long-term results of our cases comparing our data with other authors' experiences. METHODS: Clinical data of patients with SFC operated on at our institute were retrospectively analyzed. The laparoscopic approach was used in the whole series, with limited resection distally and proximally to splenic flexure and the origin ligation of left colic artery and left branch of middle colic artery. Data on the oncological long-term safety were compared to our laparoscopic series of extended right colectomy for proximal two-third transverse colon cancer and high anterior resections for sigmoid-high rectal cancer and to the main evidences in the literature, found after a comprehensive review. RESULTS: From March 2008 to May 2018, we completed 53 laparoscopic splenic flexure resections (26 female and 27 male, age 71.5 ± 15.4 years). The conversion rate was 3.8%. Most of the cases were stage II (pT3 73.5%, the mean number of lymph nodes harvested was 19.1, with positivity for malignancy in 45.3%). During the FU (43.5 months), 2 patients dropped out. Out of the 51 residual cases, 37 were alive (72.5%) and 14 are deceased (27.5%). DISCUSSION: Compared to the literature, our survival rate does not show significant differences. The other oncological outcomes seem to be comparable with the data evaluated. CONCLUSIONS: More extended resections seem not to confer an increase of the overall survival rate. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/31617095/Colonic_splenic_flexure_carcinoma:_is_laparoscopic_segmental_resection_a_safe_enough_oncological_approach DB - PRIME DP - Unbound Medicine ER -