Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic extended right hemicolectomy versus laparoscopic transverse colectomy for mid-transverse colon cancer: a multicenter retrospective study from Kanagawa Yokohama Colorectal Cancer (KYCC) study group

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

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. This study aimed to compare the surgical outcomes of laparoscopic extended right hemicolectomy (Lap-ERHC) and laparoscopic transverse colectomy (Lap-TC) for MTC.

Methods

This was a multicenter, retrospective study. 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.

Results

A total of 129 patients were enrolled, of whom 35 underwent Lap-ERHC and 94 underwent Lap-TC. There were no significant differences in tumor progression between the two groups. Operation time was significantly longer (202 min vs. 185 min, p = 0.026). We observed a higher complication rate (≥ grade 3) in the Lap-ERHC group than in the Lap-TC group (11.4% vs. 3.2%, p = 0.086). 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). The 3-year overall survival rates (stage I: 100% vs. 91.9%, p = 0.64; stage II: 100% vs. 95.5%, p = 0.46; stage III: 100% vs. 88.2%, p = 0.91, respectively) were similar between the two groups.

Conclusion

Lap-ERHC for MTC has the same long-term outcomes as Lap-TC. However, Lap-ERHC for MTC has a higher complication rate. Therefore, Lap-TC may be recommended for patients with MTC.

Trial registration

UMIN000042674

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS, Barzi A, Jemal A (2017) Colorectal cancer statistics, 2017. CA Cancer J Clin 67:177–193. https://doi.org/10.3322/caac.21395

    Article  PubMed  Google Scholar 

  2. Pisani Ceretti A, Maroni N, Sacchi M, Bona S, Angiolini MR, Bianchi P, Opocher E, Montorsi M (2015) Laparoscopic colonic resection for splenic flexure cancer: our experience. BMC Gastroenterol. https://doi.org/10.1186/s12876-015-0301-7

    Article  PubMed  PubMed Central  Google Scholar 

  3. Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA (2015) Laparoscopic colorectal surgery confers lower mortality in the elderly: a systematic review and meta-analysis of 66,483 patients. Surg Endosc Other Interv Tech 29:322–333. https://doi.org/10.1007/s00464-014-3672-x

    Article  Google Scholar 

  4. Li Z, Zou Z, Lang Z, Sun Y, Zhang X, Dai M, Mao S, Han Z (2021) Laparoscopic versus open radical resection for transverse colon cancer: evidence from multi-center databases. Surg Endosc 35:1435–1441. https://doi.org/10.1007/s00464-021-08285-5

    Article  PubMed  Google Scholar 

  5. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AMH, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol 25:3061–3068. https://doi.org/10.1200/JCO.2006.09.7758

    Article  PubMed  Google Scholar 

  6. The Colon Cancer Laparoscopic or Open Resection Study Group (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52. https://doi.org/10.1016/S1470-2045(08)70310-3

    Article  CAS  PubMed  Google Scholar 

  7. Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059. https://doi.org/10.1056/nejmoa032651

    Article  Google Scholar 

  8. Huang S, Wang X, Deng Y, Jiang W, Huang Y, Chi P (2020) Gastrocolic ligament lymph node dissection for transverse colon and hepatic flexure colon cancer: risk of nodal metastases and complications in a large-volume center. J Gastrointest Surg 24:2658–2660

    Article  Google Scholar 

  9. Wang X, Huang S, Lu X, Huang Y, Chi P (2021) Incidence of and risk factors for gastroepiploic lymph node involvement in patients with cancer of the transverse colon including the hepatic flexure. World J Surg 45:1514–1525. https://doi.org/10.1007/s00268-020-05933-0

    Article  PubMed  Google Scholar 

  10. Matsumura N, Tokumura H, Saijo F, Katayose Y (2018) Strategy of laparoscopic surgery for colon cancer of the splenic flexure: a novel approach. Surg Endosc 32:2559. https://doi.org/10.1007/s00464-017-5870-9

    Article  PubMed  Google Scholar 

  11. Okuda J, Yamamoto M, Tanaka K, Masubuchi S, Uchiyama K (2016) Laparoscopic resection of transverse colon cancer at splenic flexure: technical aspects and results. Updates Surg 68:71–75. https://doi.org/10.1007/s13304-016-0352-5

    Article  PubMed  Google Scholar 

  12. de’Angelis N, Martínez-Pérez A, Winter DC, Landi F, Vitali GC, Le Roy B, Coccolini F, Brunetti F, Celentano V, Di Saverio S, Ris F, Fuks D, Espin E, Bianchi G, Pham J, Genova P, Sobhani I, Gómez SA, Torres MT, Payá C, Gonzálvez P, Stakelum A, Zaborowski A, Sueiras-Gil A, Hevia R, Assalino M, Pezet D, Abdallah M, Ansaloni L, Birindelli A, Denet C, Solis A, Kraft M (2021) Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. Surg Endosc 35:661–672. https://doi.org/10.1007/s00464-020-07431-9

    Article  PubMed  Google Scholar 

  13. Hashiguchi Y, Muro K, Saito Y, Ito Y, Ajioka Y, Hamaguchi T, Hasegawa K, Hotta K, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kinugasa Y, Murofushi K, Nakajima TE, Oka S, Tanaka T, Taniguchi H, Tsuji A, Uehara K, Ueno H, Yamanaka T, Yamazaki K, Yoshida M, Yoshino T, Itabashi M, Sakamaki K, Sano K, Shimada Y, Tanaka S, Uetake H, Yamaguchi S, Yamaguchi N, Kobayashi H, Matsuda K, Kotake K, Sugihara K (2020) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol 25:1–42. https://doi.org/10.1007/s10147-019-01485-z

    Article  PubMed  Google Scholar 

  14. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications. Ann Surg 240:205–213. https://doi.org/10.1097/01.sla.0000133083.54934.ae

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bosman FT, Carneiro F, Hruban RH, Theise ND (2010) WHO classification of tumours of the digestive system, Fourth Edition. In: International agency for research on cancer. International Agency for Research on Cancer, p 417

  16. Brierley J, Gospodarowicz MD, Wittekind CT (2017) TNM classification of malignant tumors international union against cancer. 8th. Oxford, England: Wiley. Oesphagus including oesophagogastric junction. Wiley pp 57–62

  17. Milone M, Degiuli M, Allaix ME, Ammirati CA, Anania G, Barberis A, Belli A, Bianchi PP, Bianco F, Bombardini C, Burati M, Cavaliere D, Coco C, Coratti A, De Luca R, De Manzoni G, De Nardi P, De Rosa M, Delrio P, Di Cataldo A, Di Leo A, Donini A, Elmore U, Fontana A, Gallo G, Gentilli S, Giannessi S, Giuliani G, Graziosi L, Guerrieri M, Li Destri G, Longhin R, Manigrasso M, Mineccia M, Monni M, Morino M, Ortenzi M, Pecchini F, Pedrazzani C, Piccoli M, Pollesel S, Pucciarelli S, Reddavid R, Rega D, Rigamonti M, Rizzo G, Robustelli V, Rondelli F, Rosati R, Roviello F, Santarelli M, Saraceno F, Scabini S, Sica GS, Sileri P, Simone M, Siragusa L, Sofia S, Solaini L, Tribuzi A, Trompetto M, Turri G, Urso EDL, Vertaldi S, Vignali A, Zuin M, Zuolo M, D’Ugo D, De Palma GD (2020) Mid-transverse colon cancer and extended versus transverse colectomy: results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study. Eur J Surg Oncol 46:1683–1688. https://doi.org/10.1016/j.ejso.2020.01.006

    Article  CAS  PubMed  Google Scholar 

  18. Phillips M, Patel A, Meredith P, Will O, Brassett C (2015) Segmental colonic length and mobility. Ann R Coll Surg Engl 97:439–444. https://doi.org/10.1308/003588415X14181254790527

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Chong CS, Huh JW, Oh BY, Park YA, Cho YB, Yun SH, Kim HC, Lee WY (2016) Operative method for transverse colon carcinoma: transverse colectomy versus extended colectomy. Dis Colon Rectum 59:630–639. https://doi.org/10.1097/DCR.0000000000000619

    Article  PubMed  Google Scholar 

  20. Park HM, Lee J, Lee SY, Kim CH, Kim HR (2021) Distribution of lymph node metastasis and oncological outcomes of mid-transverse colon cancer: extended versus transverse colectomy. Color Dis 23:2007–2013. https://doi.org/10.1111/codi.15659

    Article  Google Scholar 

  21. Sato S, Sugano N, Shiozawa M, Uchiyama M, Kazama K, Kato A, Oshima T, Rino Y, Masuda M (2021) Application and outcomes of a standardized lymphadenectomy in laparoscopic right hemicolectomy requiring ligation of the middle colic artery. Tech Coloproctol 25:223–227. https://doi.org/10.1007/s10151-020-02388-2

    Article  CAS  PubMed  Google Scholar 

  22. European Society of Coloproctology Collaborating Group (2020) Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: results from an international snapshot audit. Dis Colon Rectum 63:606–618. https://doi.org/10.1097/DCR.0000000000001590

    Article  Google Scholar 

  23. Olofsson F, Buchwald P, Elmståhl S, Syk I (2016) No benefit of extended mesenteric resection with central vascular ligation in right-sided colon cancer. Color Dis 18:773–778. https://doi.org/10.1111/codi.13305

    Article  CAS  Google Scholar 

  24. McGory ML, Zingmond DS, Sekeris E, Ko CY (2007) The significance of inadvertent splenectomy during colorectal cancer resection. Arch Surg 142:668–674. https://doi.org/10.1001/archsurg.142.7.668

    Article  PubMed  Google Scholar 

  25. Iguchi K, Mushiake H, Hasegawa S, Fukushima T, Numata M, Tamagawa H, Shiozawa M, Yukawa N, Rino Y, Masuda M (2021) Evaluation of vascular anatomy for colon cancer located in the splenic flexure using the preoperative three-dimensional computed tomography angiography with colonography. Int J Colorectal Dis 36:405–411. https://doi.org/10.1007/s00384-020-03773-x

    Article  CAS  PubMed  Google Scholar 

  26. Tanaka T, Matsuda T, Hasegawa H, Yamashita K, Nakamura T, Suzuki S, Kakeji Y (2019) Arterial anatomy of the splenic flexure using preoperative three-dimensional computed tomography. Int J Colorectal Dis 34:1047–1051. https://doi.org/10.1007/s00384-019-03289-z

    Article  PubMed  Google Scholar 

  27. Golda T, Lazzara C, Zerpa C, Sobrino L, Fico V, Kreisler E, Biondo S (2020) Risk factors for ileocolic anastomosis dehiscence: a cohort study. Am J Surg 220:170–177. https://doi.org/10.1016/j.amjsurg.2019.11.020

    Article  PubMed  Google Scholar 

  28. Espin E, Vallribera F, Kreisler E, Biondo S (2020) Clinical impact of leakage in patients with handsewn vs stapled anastomosis after right hemicolectomy: a retrospective study. Color Dis 22:1286–1292. https://doi.org/10.1111/codi.15098

    Article  CAS  Google Scholar 

  29. van Oostendorp S, Elfrink A, Borstlap W, Schoonmade L, Sietses C, Meijerink J, Tuynman J (2017) Intracorporeal versus extracorporeal anastomosis in right hemicolectomy: a systematic review and meta-analysis. Surg Endosc 31:64–77. https://doi.org/10.1007/s00464-016-4982-y

    Article  PubMed  Google Scholar 

  30. Allaix ME, Degiuli M, Bonino MA, Arezzo A, Mistrangelo M, Passera R, Morino M (2019) Intracorporeal or extracorporeal ileocolic anastomosis after laparoscopic right colectomy: a double-blinded randomized controlled trial. Ann Surg 270:762–767. https://doi.org/10.1097/SLA.0000000000003519

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to express their heartfelt gratitude to Maho Sato at the Kanagawa Cancer Center who always provided carefully considered, constructive feedback and valuable comments.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Kanagawa Cancer Center, Yokohama, Japan

    Kenta Iguchi & Manabu Shiozawa

  2. Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan

    Masakatsu Numata, Keisuke Kazama, Sho Sawazaki, Yusuke Katayama, Koji Numata, Akio Higuchi, Hiroyuki Mushiake & Yasushi Rino

  3. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan

    Sumito Sato & Nobuhiro Sugano

Authors
  1. Kenta Iguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masakatsu Numata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manabu Shiozawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keisuke Kazama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sho Sawazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yusuke Katayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Koji Numata
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sumito Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Akio Higuchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Nobuhiro Sugano
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hiroyuki Mushiake
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yasushi Rino
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masakatsu Numata.

Ethics declarations

Ethics approval

This study was approved by the institutional review board of Kanagawa Cancer Center (Number 20–109) and registered with the Japanese Clinical Trials Registry as UMIN000042674 (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048696). The study was conducted based on the ethical guidelines of the Declaration of Helsinki.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Iguchi, K., Numata, M., Shiozawa, M. et al. Laparoscopic extended right hemicolectomy versus laparoscopic transverse colectomy for mid-transverse colon cancer: a multicenter retrospective study from Kanagawa Yokohama Colorectal Cancer (KYCC) study group. Int J Colorectal Dis 37, 1011–1019 (2022). https://doi.org/10.1007/s00384-022-04128-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-022-04128-4

Keywords

Search

Navigation