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Laparoscopic resection of splenic flexure colon cancers: a retrospective multi-center study with 117 cases

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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.

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Authors and Affiliations

  1. General Surgery Department, S. Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144, Rome, Italy

    Michele Grieco, Domenico Spoletini & Massimo Carlini

  2. General and Minimally Invasive Surgery, Policlinico Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy

    Diletta Cassini & Gianandrea Baldazzi

  3. General Surgery Department, S. Andrea Hospital, Corso M. Abbiate 21, 13100, Vercelli, Italy

    Enrica Soligo & Silvio Testa

  4. Statistical and Big Data Department, Elis Consulting & Labs, Via S. Sandri 81, 00159, Rome, Italy

    Emanuela Grattarola

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  1. Michele Grieco
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Correspondence to Michele Grieco.

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The authors have no conflicts of interest or financial ties that are relevant to this article to disclose.

Research involving human participants and/or animals

This research involves only human participants, no animals and it is in accordance with the 1964 Helsinki declaration. This study was first approved by the institutional Ethics Committee of Sant’Eugenio Hospital—Rome and then approved by the Institutional Ethics Committee of every participating center.

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Grieco, M., Cassini, D., Spoletini, D. et al. Laparoscopic resection of splenic flexure colon cancers: a retrospective multi-center study with 117 cases. Updates Surg 71, 349–357 (2019). https://doi.org/10.1007/s13304-018-0601-x

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