Marco Milone1, Michele Manigrasso2, Ugo Elmore3, Francesco Maione4, Nicola Gennarelli4, Fabio Rondelli5, Nunzio Velotti2, Giovanni Domenico De Palma4. 1. Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. milone.marco.md@gmail.com. 2. Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. 3. Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Vita Salute University, Via Olgettina Milano 58, 20132, Milan, Italy. 4. Department of Surgery and Advanced Technologies, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy. 5. Department of Surgical and Biomedical Sciences, University of Perugia, Piazzale Gambuli 1, 06129, Perugia, Italy.
Abstract
BACKGROUND: Provide the surgeon with a tool to decide the best surgical approach to transverse colon cancer. OBJECTIVE: To compare the surgical and oncological outcomes between transverse colectomy and extended hemicolectomy for patients with tumours of the transverse colon. DATA SOURCES: A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search terms and/or MeSH terms in all possible combinations: transverse, transversus, colectomy, hemicolectomy, segmental resection, transverse colon cancer. The last search was performed on 10 May 2018. STUDY SELECTION: Two independent authors (Mi.M. and N.V.) analysed each article and performed the data extraction independently. In case of disagreement, a third investigator was consulted (Ma.M.). Discrepancies were resolved by consensus. DATA EXTRACTION AND SYNTHESIS: Data regarding sample size, major clinical and demographic variables, oncologic outcomes and postoperative recovery and complications were extracted. MAIN OUTCOME MEASURES: Main outcomes analysed were anastomotic leakage, early mortality, hospital stay, operative time, overall complications rate, wound infection, harvested nodes and disease-free survival. RESULTS: No statistical differences were found between transverse colectomy and extended hemicolectomy in short- and long-term outcomes; our results revealed no differences in disease-free survival between the two surgical approaches. As expected, a statistically significant difference was found in favour of extended hemicolectomy in terms of number of harvested lymph nodes. CONCLUSIONS: This systematic review with meta-analysis focus on the two major approaches to transverse colon cancer. The reviewed evidence suggests that a conservative approach to transverse colon cancer is feasible and safe and oncological outcomes are comparable between a conservative and an extended surgical procedure.
BACKGROUND: Provide the surgeon with a tool to decide the best surgical approach to transverse colon cancer. OBJECTIVE: To compare the surgical and oncological outcomes between transverse colectomy and extended hemicolectomy for patients with tumours of the transverse colon. DATA SOURCES: A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search terms and/or MeSH terms in all possible combinations: transverse, transversus, colectomy, hemicolectomy, segmental resection, transverse colon cancer. The last search was performed on 10 May 2018. STUDY SELECTION: Two independent authors (Mi.M. and N.V.) analysed each article and performed the data extraction independently. In case of disagreement, a third investigator was consulted (Ma.M.). Discrepancies were resolved by consensus. DATA EXTRACTION AND SYNTHESIS: Data regarding sample size, major clinical and demographic variables, oncologic outcomes and postoperative recovery and complications were extracted. MAIN OUTCOME MEASURES: Main outcomes analysed were anastomotic leakage, early mortality, hospital stay, operative time, overall complications rate, wound infection, harvested nodes and disease-free survival. RESULTS: No statistical differences were found between transverse colectomy and extended hemicolectomy in short- and long-term outcomes; our results revealed no differences in disease-free survival between the two surgical approaches. As expected, a statistically significant difference was found in favour of extended hemicolectomy in terms of number of harvested lymph nodes. CONCLUSIONS: This systematic review with meta-analysis focus on the two major approaches to transverse colon cancer. The reviewed evidence suggests that a conservative approach to transverse colon cancer is feasible and safe and oncological outcomes are comparable between a conservative and an extended surgical procedure.
Entities:
Keywords:
Extended colectomy; Transverse colectomy; Transverse colon cancer
Authors: Michele Manigrasso; Marco Milone; Nunzio Velotti; Sara Vertaldi; Pietro Schettino; Mario Musella; Giovanni Aprea; Nicola Gennarelli; Francesco Maione; Giovanni Sarnelli; Pietro Venetucci; Giovanni Domenico De Palma; Francesco Milone Journal: World J Surg Oncol Date: 2019-11-19 Impact factor: 2.754