Laparoscopic Surgery for Splenic Flexure Cancers: Short and Long-Term Outcomes in Comparison with Conventional Open Surgery

Harji D, Watson L, Gallagher, Burke D, Sagar P and Griffiths B

Department of Colorectal Surgery, Newcastle Upon Tyne Hospitals NHS Foundation Trust, UK
Department of Colorectal Surgery, St James’s University Hospital, UK

^*Correspondance to: Deena Harji 

 PDF  Full Text DOI: 10.25107/2474-1647.1065

Abstract

Background: Laparoscopic resection of splenic flexure cancers remains controversial. This study reviews the management of splenic flexure tumours, comparing outcomes between laparoscopic (LR) and open (OR) resections.Methods: All patients undergoing surgery for a splenic flexure colonic carcinoma at two tertiary level institutions between January 2000 and July 2011 were identified. Data were collected on patient demographics, operative detail, histological data and follow up status. Data was analysed using SPSS version 19.Results: A total of 111 patients were included in the study: 40 LR and 71 OR. The overall conversion rate in the LR group was 7.5%. Oncological outcomes between the two groups were similar, with no statistically significant differences observed with regards to lymph node yield, margin status, overall survival and recurrence rates. The median length of stay in the laparoscopic group was 10 days compared to 18 days in the open group (p=0.05). No significant differences were seen between the two groups with regards to post-operative morbidity, with rates of 35.1% and 25.7% in the laparoscopic and open group respectively, p=0.30. However, the grade of complication was significantly lower in the laparoscopic group compared to the open group, with grade III Clavien- Dindo rates of 7.7% and 42.1% respectively, p=0.05.Conclusion: Our study adds to the growing evidence base advocating laparoscopic surgery as technically safe and feasible option in the operative management of splenic flexure tumours, with comparable oncological and clinical outcomes compared to open surgery.

Keywords

Splenic flexure cancer; Laparoscopic surgery

Cite the article

Harji D, Watson L, Gallagher, Burke D, Sagar P, Griffiths B. Laparoscopic Surgery for Splenic Flexure Cancers: Short and Long-Term Outcomes in Comparison with Conventional Open Surgery. Clin Surg. 2016; 1: 1065.