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18.02.2020

Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis

verfasst von: Nicola de’Angelis, Aleix Martínez-Pérez, Des C. Winter, Filippo Landi, Giulio Cesare Vitali, Bertrand Le Roy, Federico Coccolini, Francesco Brunetti, Valerio Celentano, Salomone Di Saverio, Frederic Ris, David Fuks, Eloy Espin, the SFC Study Group

Erschienen in: Surgical Endoscopy | Ausgabe 2/2021

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Abstract

Background

The surgical resection of the splenic flexure carcinoma (SFC) is challenging and the optimal surgical procedure for SFCs remains a matter of debate. The present study aimed to compare in a multicenter European sample of patients the short- and long-term outcomes of extended right (ERC) vs. left (LC) vs. segmental left colectomy (SLC) for SFCs.

Methods

This retrospective multicenter study analyzed the surgical and oncological outcomes of SFC patients undergoing elective curative intent surgery between 2000 and 2018. Descriptive and exploratory analyses were first conducted on the whole sample. Outcomes of the different procedures (ERC vs. LC vs. SLC) were then compared using propensity score matching for multilevel treatment. Overall (OS) and disease-free survival (DFS) were evaluated by Kaplan–Meier method.

Results

From a total of 399 SFC patients, 143 (35.8%) underwent ERC, 131 (32.8%) underwent LC, and 125 (31.4%) underwent SLC. Overall, 297 (74.4%) were laparoscopic procedures. An increase in operative time, time to flatus, time to regular diet, and hospital stay was observed with the progressive extension of SFC resection. ERC was associated with significantly increased risk of postoperative ileus compared to both LC and SLC. A significantly greater number of lymph nodes were retrieved by ERC, but the objective of at least 12 retrieved lymph nodes was achieved in 85% of patients, without procedure-related differences. No differences were observed in OS or DFS between ERC, LC, and SLC.

Conclusion

The present study supports the resection of SFCs by colon-sparing surgical techniques, such as SLC.

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Titel: Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis
verfasst von: Nicola de’Angelis
Aleix Martínez-Pérez
Des C. Winter
Filippo Landi
Giulio Cesare Vitali
Bertrand Le Roy
Federico Coccolini
Francesco Brunetti
Valerio Celentano
Salomone Di Saverio
Frederic Ris
David Fuks
Eloy Espin
the SFC Study Group
Publikationsdatum: 18.02.2020
Verlag: Springer US
Erschienen in: Surgical Endoscopy / Ausgabe 2/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07431-9

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Abstract

Background

Methods

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Conclusion

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