Q Chenevas-Paule1, B Trilling1,2, P Y Sage1, E Girard1,2, J L Faucheron3,4,5. 1. Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France. 2. University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France. 3. Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr. 4. University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr. 5. Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France. JLFaucheron@chu-grenoble.fr.
Abstract
BACKGROUND: There is ongoing debate regarding surgical treatment of splenic flexure cancer. The main points of controversy include the appropriate extent of colon resection, either to the right or to the left, and the appropriate extent of lymph-node dissection. The aim of this study was to review our experience in laparoscopic treatment of splenic flexure cancer cases and to compare our data to the recent literature. METHODS: Consecutive patients, operated on for splenic flexure colon carcinoma at a single institution between April 2005 and January 2013, were included in the study. Exclusion criteria were a previous history of colorectal cancer, recurrent colonic cancer, emergency cases with an obstructive tumor or a perforated tumor with peritonitis, synchronous cancer, palliative surgery, and a past history of colorectal resection. Patients underwent laparoscopic segmental left colectomy with ligation of the left branch of the middle colic and of the left colic artery. Patient characteristics, operative and postoperative outcomes, and long-term technical, functional, and oncological results from a prospectively maintained database were retrospectively analyzed. After hospital discharge, standardized follow-up was performed at 1 month postoperatively, then every 3 months during the first 2 years, and every 6 months thereafter, for a total of 5 years. RESULTS: A total of 28 consecutive patients (16 males) with a median age of 71.8 years (range 42.5-88.8 years) were included. Ninety-day mortality was 3.5% and surgical morbidity was 21.5% with anastomotic leak rate of 10.7%. All survivors experienced good or very good functional results. During a median follow-up period of 50.9 months, eight patients (28.5%) presented with a recurrence. The 5-year overall and disease-free survival rates were 46.3% and 39.2%, respectively. CONCLUSIONS: Segmental left colectomy for splenic flexure carcinoma is associated with reasonably low morbidity and very good functional results. However, survival rates are low.
BACKGROUND: There is ongoing debate regarding surgical treatment of splenic flexure cancer. The main points of controversy include the appropriate extent of colon resection, either to the right or to the left, and the appropriate extent of lymph-node dissection. The aim of this study was to review our experience in laparoscopic treatment of splenic flexure cancer cases and to compare our data to the recent literature. METHODS: Consecutive patients, operated on for splenic flexure colon carcinoma at a single institution between April 2005 and January 2013, were included in the study. Exclusion criteria were a previous history of colorectal cancer, recurrent colonic cancer, emergency cases with an obstructive tumor or a perforated tumor with peritonitis, synchronous cancer, palliative surgery, and a past history of colorectal resection. Patients underwent laparoscopic segmental left colectomy with ligation of the left branch of the middle colic and of the left colic artery. Patient characteristics, operative and postoperative outcomes, and long-term technical, functional, and oncological results from a prospectively maintained database were retrospectively analyzed. After hospital discharge, standardized follow-up was performed at 1 month postoperatively, then every 3 months during the first 2 years, and every 6 months thereafter, for a total of 5 years. RESULTS: A total of 28 consecutive patients (16 males) with a median age of 71.8 years (range 42.5-88.8 years) were included. Ninety-day mortality was 3.5% and surgical morbidity was 21.5% with anastomotic leak rate of 10.7%. All survivors experienced good or very good functional results. During a median follow-up period of 50.9 months, eight patients (28.5%) presented with a recurrence. The 5-year overall and disease-free survival rates were 46.3% and 39.2%, respectively. CONCLUSIONS: Segmental left colectomy for splenic flexure carcinoma is associated with reasonably low morbidity and very good functional results. However, survival rates are low.
Authors: F Rouffet; J M Hay; B Vacher; A Fingerhut; A Elhadad; Y Flamant; C Mathon; A Gainant Journal: Dis Colon Rectum Date: 1994-07 Impact factor: 4.585
Authors: Nicola de'Angelis; Eloy Espin; Frederic Ris; Filippo Landi; Bertrand Le Roy; Federico Coccolini; Valerio Celentano; Angela Gurrado; Denis Pezet; Giorgio Bianchi; Riccardo Memeo; Giulio C Vitali; Alejandro Solis; Christine Denet; Salomone Di Saverio; Gian Luigi de'Angelis; Miquel Kraft; Paula Gonzálvez-Guardiola; Aine Stakelum; Fausto Catena; David Fuks; Des C Winter; Mario Testini; Aleix Martínez-Pérez Journal: World J Emerg Surg Date: 2021-04-29 Impact factor: 5.469
Authors: Moon Jin Kim; Ji Hoon Kim; Yoon Suk Lee; Bong Hyeon Kye; Hyeon Min Cho; Hyung Jin Kim; Won Kyung Kang Journal: Ann Surg Treat Res Date: 2021-10-29 Impact factor: 1.859