학술논문
Laparoscopic resection of splenic flexure colon cancers: a retrospective multi-center study with 117 cases.
Document Type
Academic Journal
Author
Grieco M; General Surgery Department, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy. dr.griecomichele@gmail.com.; Cassini D; General and Minimally Invasive Surgery, Policlinico Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy.; Spoletini D; General Surgery Department, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.; Soligo E; General Surgery Department, S. Andrea Hospital, Corso M. Abbiate 21, 13100, Vercelli, Italy.; Grattarola E; Statistical and Big Data Department, Elis Consulting & Labs, Via S. Sandri 81, 00159, Rome, Italy.; Baldazzi G; General and Minimally Invasive Surgery, Policlinico Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy.; Testa S; General Surgery Department, S. Andrea Hospital, Corso M. Abbiate 21, 13100, Vercelli, Italy.; Carlini M; General Surgery Department, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.
Source
Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 101539818 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2038-3312 (Electronic) Linking ISSN: 2038131X NLM ISO Abbreviation: Updates Surg Subsets: MEDLINE
Subject
Language
English
Abstract
The objective is to investigate the short- and long-term outcomes of laparoscopic resections of splenic flexure colon cancers in three Italian high-volume centers. The laparoscopic resection of splenic flexure colon cancers is a challenging procedure and has not been completely standardized, mainly due to the technical difficulty, the arduous identification of major blood vessels, and the problems associated with anastomosis construction. In this retrospective cohort observational study, a consecutive series of patients treated in three Italian high-volume centers with elective laparoscopic resection of the splenic flexure for cancer is analyzed. The observational period was from January 2008 to August 2017. Patient demographics and clinical features, operative data, and short- and long-term outcomes were prospectively recorded in a specific database and were retrospectively analyzed. During the observation period, 117 patients were selected. Conversion to open surgery was necessary in 15 patients (12.8%). Of 102 complete laparoscopic procedures, multi-visceral resection was performed in 13 cases (12.7%). Postoperative surgical complications occurred in 13 patients (12.7%), with 3 cases of anastomotic leak (2.9%) and 3 cases of re-operation (2.9%). The postoperative mortality in this population was null. The 5-year overall survival rate was 84.3%, and the 5-year disease-free survival rate was 87.8%. Laparoscopic resection of the splenic flexure is feasible and safe in high-volume centers. Compared to the results of other laparoscopic colonic resections, the short- and long-term outcomes are similar, but the conversion rate is higher.