4.4 Article

Best surgical approach for splenic flexure colon cancers: Extended versus segmental resection?

Journal

AMERICAN JOURNAL OF SURGERY
Volume 225, Issue 3, Pages 454-459

Publisher

EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjsurg.2022.11.014

Keywords

Splenic flexure colon carcinoma; Surgery; Extended right colectomy; Segmental colonic resection; Left colectomy

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A retrospective review found no significant difference in surgical and oncologic outcomes between segmental colon resections and extended colectomies for splenic flexure colon cancer.
Background: The optimal surgical treatment approach for splenic flexure colon cancers remains controversial regarding the type of resection. Methods: We hypothesized that both extended and segmental resections have similar surgical and oncologic outcomes. A retrospective review of prospectively collected database was performed on all patients who had colectomy for splenic flexure colon cancer between 1996 and 2018. Results: Of 142 patients, 119 underwent extended resection; therefore, this group was compared with the group which underwent segmental resection (n = 23). The groups were similar in age, sex, ASA scores, operative times, estimated blood loss, hospital length of stay, and postoperative complication rates (p > 0.05). Median follow-up was 9.58 years (IQR:5.46-16.48). Multivariable regression models demonstrated no significant association be-tween resection approach and disease-free survival (HR 1.63 [95%CI:0.91-2.92]), as well as overall survival (HR 1.80 [95%CI:0.97; 3.36]). Conclusion: In the treatment of splenic flexure colon cancer, segmental colon resections have similar oncologic outcomes when compared to extended colectomies.

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