Is Segmental Colon Resection an Alternative Treatment for Splenic Flexure Cancer?

J Laparoendosc Adv Surg Tech A. 2019 May;29(5):621-626. doi: 10.1089/lap.2019.0041. Epub 2019 Apr 5.

Abstract

Background: Optimal elective surgery for splenic flexure cancer is unclear. Three types of surgical treatment methods are commonly used, subtotal colectomy (STC), left hemicolectomy (LHC), and segmental colon resection (SCR), but consensus is lacking as to which is the optimal method. Materials and Methods: We retrospectively compared clinicopathological and operative results, morbidity, mortality, and long-term survival in patients with splenic flexure cancer who underwent surgery between 1998 and 2018. Results: The study included 124 patients in the study. Following retrospective evaluation of the database, patients were classified into one of three groups according to the surgical approach: (1) STC (n: 41), (2) LHC (n: 55), and (3) SCR (n: 28). No statistically significant differences were found between groups regarding operative results, hospital stay, pathological data, mortality, recurrence, or long-term survival outcomes. Conclusion: Our results suggest that surgical procedures such as STC and LHC have no statistically significant clinical benefits over less aggressive approaches such as SCR. We thus conclude that SCR seems both a safe and effective alternative for splenic flexure tumors.

Keywords: left hemicolectomy; segmental colon resection (SCR); splenic flexure cancer; subtotal colectomy.

MeSH terms

  • Aged
  • Anastomosis, Surgical*
  • Colectomy / methods*
  • Colon, Transverse / surgery*
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / surgery*
  • Retrospective Studies
  • Splenic Neoplasms / surgery
  • Treatment Outcome