Journal Basic Info

  • Impact Factor: 1.995**
  • H-Index: 8
  • ISSN: 2474-1647
  • DOI: 10.25107/2474-1647
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Robotic Surgery
  •  Otolaryngology - Head and Neck Surgery
  •  Minimally Invasive Surgery
  •  Thoracic Surgery
  •  Endocrine Surgery
  •  Emergency Surgery
  •  Obstetrics Surgery
  •  Gastroenterological Surgery

Abstract

Citation: Clin Surg. 2021;6(1):3089.Research Article | Open Access

Splenic Flexure Cancer: Segmental Colonic Resection, Left Hemicolectomy, Extended Right Hemicolectomy or Total Colectomy? Short-Term and Long-Term Outcomes

Bono D1*, Galati S2 , Potenza E2 , Loddo F2 , Bonaccors L3 , Viora T3 and Saracco R2

1 Department of Surgery, Presidio Hospital S.S. Peter and Paul, First Aid, Borgosesia, Piedmont, Italy 2 Department of Surgery, Presidio Ospedaliero Martini, 71 via Tofane, 10141, Turin, Piedmont, Italy 3 Department of Surgery, San Giovanni Bosco Hospital, 3 Piazza del Donatore di sangue, 10154, Turin, Italy

*Correspondance to: Dario Bono 

 PDF  Full Text DOI: 10.25107/2474-1647.3089

Abstract

Introduction: Splenic flexure tumors are quite rare, accounting for 2% to 8% of all colorectal cancers. The heterogeneity of the vascular support and lymphatic drainage of the splenic flexure make the surgical management complex and non-standardized. The aim of the study is to compare the four surgical techniques (extended right hemicolectomy, left hemicolectomy, segmental colonic resection, and total colectomy) in terms of short-term and long-term outcomes. Materials and Methods: Consecutive patients from two hospitals of Turin (the Martini hospital and the San Giovanni Bosco hospital) between September 1998 and March 2020 have surgical visit for splenic flexure cancer. The data reported in the database include preoperative, postoperative, histopathological characteristics, and survival results. Univariate and multivariate analysis are performed to evaluate the confounding factors influencing overall and disease-free survival. Results and Discussion: A total of 173 patients treated for splenic flexure tumors are included in the study. The four groups are similar on the baseline characteristics of the patients. Clavien Dindo ? 3 postoperative complications and 30-day mortality are comparable in the four groups (p=0.216 e p=0.213). Five-year overall survival and progression-free survival did not show significant differences between the four surgical techniques (p=1.08 e p=0.28). No statistically significant differences were found between the four groups for baseline patient characteristics, intraoperative outcomes, postoperative complications, and TNM staging. Conclusion: Segmental colonic resection, extended right hemicolectomy, left hemicolectomy and total colectomy show no significant difference in short-term and oncological outcomes in cancer of the splenic flexure. Further studies with a higher level of evidence are needed.

Keywords

Cancer of the splenic flexure; Left hemicolectomy; Extended right colectomy; Limited resection; Resection of the splenic flexure; Segmental colonic resection

Cite the article

Bono D, Galati S, Potenza E, Loddo F, Bonaccors L, Viora T, et al. Splenic Flexure Cancer: Segmental Colonic Resection, Left Hemicolectomy, Extended Right Hemicolectomy or Total Colectomy? Short-Term and Long-Term Outcomes. Clin Surg. 2021; 6: 3089..

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