Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group

Maurizio Degiuli, Rossella Reddavid, Fulvio Ricceri, Francesca Di Candido, Monica Ortenzi, Ugo Elmore, Claudio Belluco, Riccardo Rosati, Marco Guerrieri, Antonino Spinelli, Paola De Nardi, Desiree Cianflocca, Felice Borghi, Daniela Rega, Paolo Delrio, Marco Milone, Maria Milone, Giovanni Domenico De Palma, Angelo Restivo, Attilio RestivoSimona Deidda, Silvia Deidda, Silvio Testa, Mario Scansetti, Gianandrea Baldazzi, Diletta Cassini, Stefano Scabini, Marco Sparavigna, Sergio Gentilli, Manuela Monni, Denise Michela Monni, Francesco Marchegiani, Matteo Zuin, Vincenzo Sorisio, Edoardo Castelano, Roberto Polastri, Fabio Maiello, Micaela Piccoli, Francesca Pecchini, Alessandro Ferrero, Michela Mineccia, Dario Parini, Domenico D'Ugo, Alberto Biondi, Davide Cavaliere, Leonardo Solaini, Massimo Carlini, Domenico Spoletini, Matteo Olivieri, Gabriele Anania, Cristina Bombardini, Claudio Coco, Gianluca Rizzo, Marco Rigamonti, Michele Zuolo, Andrea Belli, Francesco Bianco, Flaviana Bianco, Franco Roviello, Sara Pollesel, Alberto Di Leo, Francesco Carafa, Pietro Paolo Bianchi, Giuseppe Giuliani, Andrea Muratore, Patrizia Marsanic

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

BACKGROUND: Global experience with splenic flexure cancer is limited because of its low incidence. Both limited (segmental) and extended resections are performed, because agreement on which is the adequate procedure has not been reached. OBJECTIVE: The purpose of this study was to investigate whether segmental resection is as safe and effective as extended resection. DESIGN: This nationwide retrospective cohort study included all consecutive resections of splenic flecure cancer between January 2006 and December 2016 using data from the National Colorectal Cancer Network of the Italian Society of Surgical Oncology following the guidelines set out in the STROBE statement. SETTING: Data were obtained for 31 Italian Referral Centers for Colorectal Surgery. PATIENTS: A total of 1304 patients were submitted to resection of the splenic flexure (n = 791, 60.7%) or extended procedures (extended right and left colectomies; n = 513, 39.3%). MAIN OUTCOME MEASURES: We evaluated Clavien-Dindo ≥3 postoperative complications and oncological (number of lymph nodes removed, length of free proximal and distal margins, rate of R0 resections) and survival outcomes. RESULTS: The 2 arms were well balanced in regard to sex, BMI, ASA and Eastern Cooperative Oncology Group scores, and disease stage. Limited resection was performed more frequently using a minimally invasive approach (62.1% vs 50.9%, p < 0.001) and with shorter operation times than extended procedures (165 vs 189 minutes, p < 0.001), but the same Clavien-Dindo ≥3 postoperative complications (6.44% vs 6.43%, p = 0.99), 30-day mortality (0.63% vs 0.38%), oncological outcomes, and survival rates (5-year overall survival 0.84 vs 0.83, 5-year progression-free survival 0.85 vs 0.84). LIMITATIONS: There are limitations inherent to the retrospective nature of the study and a potential lack of consistency in treatment across centers over time. Indications as to why a specific operation was chosen were based mostly on surgeons' beliefs. CONCLUSIONS: Segmental resection is a safe and effective treatment option for cancer of the splenic flexure. See Video Abstract at http://links.lww.com/DCR/B307.
Lingua originaleEnglish
pagine (da-a)1372-1382
Numero di pagine11
RivistaDISEASES OF THE COLON &amp; RECTUM
Volume63
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Cancer of the splenic flexure
  • Extended left colectomy
  • Segmental colonic resection
  • Limited resection
  • Resection of the splenic flexure
  • Extended right colectomy

Fingerprint

Entra nei temi di ricerca di 'Segmental Colonic Resection Is a Safe and Effective Treatment Option for Colon Cancer of the Splenic Flexure: A Nationwide Retrospective Study of the Italian Society of Surgical Oncology-Colorectal Cancer Network Collaborative Group'. Insieme formano una fingerprint unica.

Cita questo