Operative Method for Transverse Colon Carcinoma: Transverse Colectomy Versus Extended Colectomy

Chong, Choon Seng; Huh, Jung Wook; Oh, Bo Young; Park, Yoon Ah; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong

doi:10.1097/dcr.0000000000000619

Cited by 29 publications

(65 citation statements)

References 26 publications

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“…According to Chong et al this is due to the possibility of these tumors giving rise to lymph-node metastases through both superior and inferior mesenteric vessels. Another reason for the poor survival rates could be the proximity to other organs which often requires a more aggressive surgery [9]. These are potential sources of complications after surgery and have led to the exclusion of transverse tumor cases in many large prospective randomized trials [10].…”

Section: Discussionmentioning

confidence: 99%

Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study

Milone

Degiuli²,

Allaix

et al. 2020

European Journal of Surgical Oncology

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Introduction: Transverse colon cancer (TCC) is poorly studied, and TCC cases are often excluded from large prospective randomized trials because of their complexity and their potentially high complication rate. The best surgical approach for TCC has yet to be established. The aim of this large retrospective multicenter Italian series is to investigate the advantages and disadvantages of both hemicolectomy and transverse colectomy in order to identify the best surgical approach. Materials and methods: This was a retrospective cohort study of patients with mid-transverse colon cancer treated with a segmental colon resection or an extended hemicolectomy (right or left) between 2006 and 2016 in 28 high-volume (more than 70 procedures/year) Italian referral centers for colorectal surgery.Results: The study included 1529 patients, 388 of whom underwent a segmental resection while 1141 underwent an extended resection. A higher number of complications has been reported in the segmental group than in the extended group (30.1% versus 23.6%; p 0.010). In 42 cases the main complication was the anastomotic leak (4.4% versus 2.2%; p 0.020). Recovery outcomes also showed statistical differences: time to first flatus (p 0.014), time to first mobilization (p 0.040), and overall hospital stay (p < 0.001) were significantly shorter in the extended group. Even if overall survival were similar between the groups (95.1% versus 97%; p 0.384), 3-year disease-free survival worsened after segmental resection (78.1% versus 86.2%; p 0.001). Conclusions: According to our results, an extended right colon resection for TCC seems to be surgically safer and more oncologically valid.

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Section: Discussionmentioning

confidence: 99%

Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study

Milone

Degiuli²,

Allaix

et al. 2020

European Journal of Surgical Oncology

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“…The inferior mesenteric vessels and the left branch of the middle colic vessels were ligated at their origins, and a regional lymphadenectomy was performed. Intestinal continuity was restored by a side-to-end mechanical colorectal anastomosis 9,17,18 .…”

Section: Methodsmentioning

confidence: 99%

“…At the best of our knowledge, only few studies investigated a segmental splenic flexure resection compared to extended colectomy, with the goal of proving the oncological equivalence between these two approaches. Moreover only the 14% of surgeons seem to perform segmental resection for splenic flexure cancer 6,9–11 .…”

Section: Introductionmentioning

confidence: 99%

Treatment of splenic flexure colon cancer: a comparison of three different surgical procedures: Experience of a high volume cancer center

Rega

Pace

Scala

et al. 2019

Sci Rep

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Extended right or left hemicolectomy are the most common surgical treatments for splenic flexure colon cancer. Extended resection (including distal pancreasectomy and/or splenectomy), has been often indicated for the treatment for the splenic flexure cancer, because the lymphatic drainage at this site is poorly defined and assumed as heterogeneous. Between January 2006 and May 2016, 103 patients with splenic flexure colon cancer were enrolled in the study. We evaluated the clinicopathological findings and outcomes of all patients and associated them to the different surgical treatment. Out of 103 selected cases an extended right hemicolectomy was performed in 22 (21.4%) patients, an extended left hemicolectomy in 24 (23.3%) patients, a segmental resection of the splenic flexure in 57 (55.3%) patients; the combined resection of adjacent organs showing tumor adherence was carried out in 11 (10.7%) patients. The tumor infiltrated near organs (T4) in 5 patients. No significant differences in complications were found among the three groups. In all groups no differences were found in the total number of harvested lymphnodes. After a median follow-up of 42 months, 30 recurrences and 19 deaths occurred (12 for tumor progression). There was no difference in overall and progression free survival among the three different surgical treatments. According to our results, the partial resection of splenic flexure was not associated with a worse prognosis and it was leading for a satisfactory oncological outcome. It is our opinion that the extended surgery is seldomly indicated to cure splenic flexure cancer.

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“…Transverse colon cancer has a 5-year survival rates of 25-50% which is significantly poorer outcome compared with cancers in the other part of the colon [5] TC cancer has various number of technical description but lacks about indications of real gold standard technique. Due to the risk of vascular insufficiency and for the anatomical location in proximity of superior mesenteric artery and technical difficulties to splenic and hepatic flexure takedown, TC and EC are two challenging procedures.…”

Section: Discussionmentioning

confidence: 99%

“…TC had lower harvested lymph nodes (LNs) and small size of colon resection. Independent prognostic factors for DFS were node-positive disease, vascular invasion, and ulcerative morphology (Figures 2 and 3) [5]. Guan et al found inferior number of harvested nodes in transverse resection but similar rate of nodes positivity between transverse resection and EC.…”

mentioning

confidence: 95%

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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Operative Method for Transverse Colon Carcinoma: Transverse Colectomy Versus Extended Colectomy

Cited by 29 publications

References 26 publications

Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study

Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study

Treatment of splenic flexure colon cancer: a comparison of three different surgical procedures: Experience of a high volume cancer center

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

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