There have also been few studies on the safety and feasibility of laparoscopic surgery for SFCC. Splenic flexure colon cancer (SFCC) is a rare disease that accounts for 2%-8% of colorectal cancers, and the extent of surgery and resection is still debatable. Therefore, Lap-TC may be recommended for patients with MTC. However, Lap-ERHC for MTC has a higher complication rate. Lap-ERHC for MTC has the same long-term outcomes as Lap-TC. 88.2%, p = 0.91, respectively) were similar between the two groups. The 3-year overall survival rates (stage I: 100% vs. Three patients (8.6%) who underwent Lap-ERHC developed anastomotic leakage none of the patients who underwent Lap-TC had this complication (p = 0.018). We observed a higher complication rate (≥ grade 3) in the Lap-ERHC group than in the Lap-TC group (11.4% vs. Operation time was significantly longer (202 min vs. There were no significant differences in tumor progression between the two groups. We surveyed eight hospitals, by questionnaire, on MTC surgery policies and retrospectively compared the short- and long-term surgical outcomes for patients with MTC who underwent Lap-ERHC or Lap-TC between January 2008 and December 2019.Ī total of 129 patients were enrolled, of whom 35 underwent Lap-ERHC and 94 underwent Lap-TC. This was a multicenter, retrospective study. This study aimed to compare the surgical outcomes of laparoscopic extended right hemicolectomy (Lap-ERHC) and laparoscopic transverse colectomy (Lap-TC) for MTC. The laparoscopic surgery approach for mid-transverse colon cancer (MTC) varies depending on tumor characteristics and the guidelines implemented by each surgeon the optimal surgical procedure for MTC has not been established. Moreover, laparoscopic surgery appears to provide excellent long-term cancer outcomes. Overall (P = 0.793) as well as cancer-specific survival (P = 0.63) did not differ between the two groups.Įlective laparoscopic surgery for stage I-III SFC is feasible and associated with improved short-term postoperative outcomes compared to open surgery. Length of stay was notably shorter in the LapGroup (P = 0.001). OpenGroup presented a higher incidence of overall (P = 0.02) and surgery-related complications (P = 0.05), but a similar rate of severe complications (P = 0.75). After 1:1 propensity score matching, 130 patients in the laparoscopic group (LapGroup) were compared with 130 patients in the open surgery group (OpenGroup).Īfter PSM, the two groups were comparable for demographic and clinical parameters. From a cohort of 641 cases, 484 patients with stage I-III SFC submitted to elective surgery with curative intent were selected. This was an international multicentre retrospective cohort study that analysed patients from 10 tertiary referral centres. This study aimed to determine the role of laparoscopic surgery in the treatment of SFC, comparing short- and long-term outcomes with open surgery. Literature is based on small single-centre series, while randomized controlled studies comparing open and laparoscopic treatment for colon cancer excluded SFC. Surgical treatment of splenic flexure cancer (SFC) still presents some debated issues, including the role of laparoscopic surgery. As regard major postoperative complications, one case of postoperative acute pancreatitis and one case of postoperative bleeding from the anastomotic suture line were reported.Īlthough our experience is limited and appropriate indications must be set by future randomized studies, we believe that laparoscopic resection with intracorporeal anastomosis appears feasible and safe for patients affected by splenic flexure cancer. Mean operative time was 190 min and mean estimated blood loss was equal to 55 ml. The mean number of harvested lymph nodes was 20.8. Specimen mean length was 21.2 cm, while the distance of distal and proximal resection margin from tumor site was 6.5 and 11.5 respectively. In 7 cases the anastomosis was performed intracorporeally. Intraoperative, pathologic and postoperative data from patients undergoing laparoscopic splenic flexure resection were analyzed to assess oncological safety as well as early and medium-term outcomes.įrom October 2005 to May 2014 laparoscopic splenic flexure resection was performed in 23 patients.Ĭonversion rate was nihil. This study reviews two Institutions experience in laparoscopic treatment of left colonic flexure cancer. Laparoscopic approach is still considered a challenging procedure. The treatment of colon cancer located in splenic flexure is not standardized.