A Transverse Colectomy is as Safe as an Extended Right or Left Colectomy for Mid‐Transverse Colon Cancer

Leijssen, Lieve G.J.; Dinaux, Anne M.; Amri, Ramzi; Kunitake, Hiroko; Bordeianou, Liliana; Berger, David L.

doi:10.1007/s00268-018-4582-1

Cited by 19 publications

(68 citation statements)

References 30 publications

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“…Segmental colectomy for tumours of the distal transverse colon and splenic flexure was similarly defined as resection of a length of transverse colon and proximal descending colon with ligation of the supplying middle colic vessels at its origin and where required ligation of the left colic vessel[13,14]. Extended colectomy included both left and right extended colectomy[2,5,[10][11][12]14] and sub-total colectomy[13]. All studies were published between 2013 and 2020.Overall a total of 3395 patients were included in the final analysis.Enrolment of patients spanned over29 years (1989-2018).…”

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“…There was no difference in disease-free survival with segmental compared to extended colectomy (OR 0.88, 95% CI 0.59-1.34, P = 0.56)(Figure 3b). The median follow-up ranged from 37 to 60 months(Table 1)[5,[10][11][12][13][14].Seven studies including 2584 patients reported comparative datafor all-cause mortality on long-term follow-up[2,5,[10][11][12][13][14]. There was no difference in overall survival between the segmental and extended colectomy groups (OR 0.98, 95% CI 0.68-1.4, P = 0.9;…”

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Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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There is no consensus on the appropriate extent of oncological resection for tumours of the transverse colon. Concerns regarding tumour factors such as pattern of lymph node spread and technical factors such as anastomotic perfusion lead to a variety of procedures being performed. Operations such as sub-total colectomy, extended right hemicolectomy, left hemicolectomy, transverse colectomy and segmental resection are all frequently performed for tumours of similar location [1-5].

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Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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“…This means that D2 LFN versus D3 LFN in Japanese classification does not have any difference in DFS and OS ( Figure 4). For more results, it is necessary defining traverse colon tumor as a tumor of mid-transverse colon or on the right or left splenic flexure too and prospective trials with inclusion and exclusion criteria are needed to have clear oncological results and post-operative complications [2].…”

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confidence: 99%

“…For TNM noticed that OS and DSF were similar between the two groups but there were fewer lymph nodes harvested and worse short-outcomes in TC group. TC group was also correlated with poor histopathological features and disease recurrence [2]. van Rongen et al have identified 103 patients, 34 TC/69 EC derived from the database stages I-II, 5-year survival was slightly higher for the hemicolectomy group (65% vs. 55%) but this difference did not reach statistical significance (p = 0.38, hazard ratio 1.4, 95% CI 0.6-3.1).…”

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Cancer of the Transverse Colon: Comparison of Extended Right or Left Hemicolectomy versus Transverse Colectomy

Coco

Leanza²

2020

Open Access Maced J Med Sci

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The transverse colon is the part of colon between right and left colon from right flexure to splenic flexure. Standard surgical treatment involves either extended colectomy (EC) or transverse colectomy (TC), depending on the location of the tumor. The aim of the present study was to compare anastomotic leakage, hospital stay, operative time, overall complications rate, harvested nodes overall survival, and disease-free survival comparing EC versus TC.

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“…However, subgroup analysis revealed that for the larger tumors (>5 cm), there was a survival advantage following extended colectomy Leijssen et al 14 around one-third of the procedures were performed by laparoscopic approach. These two studies also noted an increasing trend of laparoscopic surgery and decreasing numbers of transverse colectomy in the latter half of the study period.…”

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Surgical management of adenocarcinoma of the transverse colon: What should be the extent of resection?

Roy

Kumar

2020

Annals of Gastroent Surgery

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Transverse colon, owing its origin to midgut and hindgut and harbouring a flexure at both ends, continues to pose a surgical challenge. When compared to the rest of the colon, transverse colon adenocarcinoma is relatively uncommon. These cancers usually present late and lie in close proximity to the stomach, omentum, and pancreas. Adequate lymphadenectomy entails dissection around and ligation of the middle colic vessels. Hence, resectional surgery for transverse colon carcinoma is considered difficult. This is more so because of the variation of arterial and venous anatomy. From this perspective, the surgeon is tempted to perform a more radical operation like extended right or left hemicolectomy to secure an adequate lymphadenectomy. Such a cancer has also been dealt with a more limited transverse colectomy with colo‐colic anastomosis. For all these reasons, patients with transverse colon adenocarcinoma were excluded from randomised trials which compared laparoscopic resection with traditional open operation. Surgical literature is yet to establish a definite operation for transverse colon cancer and the exact procedure is often dictated by surgeon's preference. This is primarily because this is an uncommon cancer. The rapid adoption of laparoscopic operation favoured extended colectomy as transverse colectomy can be difficult by minimally invasive technique. However, in the recent past, cohort studies and meta‐analyses have shown equivalent oncological outcome between transverse colectomy and extended colectomy. It is time to resurrect transverse colectomy and consider it equivalent to its radical counterpart for cancers around the mid‐transverse colon.

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A Transverse Colectomy is as Safe as an Extended Right or Left Colectomy for Mid‐Transverse Colon Cancer

Abstract: Our study underlines the oncological safety of a transverse colectomy for mid-transverse colon cancer. Although TC tumors were associated with poorer histopathological features, survival rates were comparable.

Cited by 19 publications

References 30 publications

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

Cancer of the Transverse Colon: Comparison of Extended Right or Left Hemicolectomy versus Transverse Colectomy

Surgical management of adenocarcinoma of the transverse colon: What should be the extent of resection?

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