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Short- and long-term outcomes after transverse versus extended colectomy for transverse colon cancer. A systematic review and meta-analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Provide the surgeon with a tool to decide the best surgical approach to transverse colon cancer.

Objective

To compare the surgical and oncological outcomes between transverse colectomy and extended hemicolectomy for patients with tumours of the transverse colon.

Data sources

A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search terms and/or MeSH terms in all possible combinations: transverse, transversus, colectomy, hemicolectomy, segmental resection, transverse colon cancer. The last search was performed on 10 May 2018.

Study selection

Two independent authors (Mi.M. and N.V.) analysed each article and performed the data extraction independently. In case of disagreement, a third investigator was consulted (Ma.M.). Discrepancies were resolved by consensus.

Data extraction and synthesis

Data regarding sample size, major clinical and demographic variables, oncologic outcomes and postoperative recovery and complications were extracted.

Main outcome measures

Main outcomes analysed were anastomotic leakage, early mortality, hospital stay, operative time, overall complications rate, wound infection, harvested nodes and disease-free survival.

Results

No statistical differences were found between transverse colectomy and extended hemicolectomy in short- and long-term outcomes; our results revealed no differences in disease-free survival between the two surgical approaches. As expected, a statistically significant difference was found in favour of extended hemicolectomy in terms of number of harvested lymph nodes.

Conclusions

This systematic review with meta-analysis focus on the two major approaches to transverse colon cancer. The reviewed evidence suggests that a conservative approach to transverse colon cancer is feasible and safe and oncological outcomes are comparable between a conservative and an extended surgical procedure.

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Author information

Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy

    Marco Milone, Michele Manigrasso & Nunzio Velotti

  2. Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Vita Salute University, Via Olgettina Milano 58, 20132, Milan, Italy

    Ugo Elmore

  3. Department of Surgery and Advanced Technologies, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy

    Francesco Maione, Nicola Gennarelli & Giovanni Domenico De Palma

  4. Department of Surgical and Biomedical Sciences, University of Perugia, Piazzale Gambuli 1, 06129, Perugia, Italy

    Fabio Rondelli

Authors
  1. Marco Milone
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  2. Michele Manigrasso
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  3. Ugo Elmore
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  4. Francesco Maione
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  5. Nicola Gennarelli
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  6. Fabio Rondelli
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  7. Nunzio Velotti
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  8. Giovanni Domenico De Palma
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Contributions

Milone M: conception, design, interpretation of the data and drafting of the article; Manigrasso M, Elmore U, Rondelli F, Maione F, Velotti N: acquisition, analysis and interpretation of the data; De Palma GD: interpretation of the data and critical revisions; De Palma GD: critical revisions and final approval.

Corresponding author

Correspondence to Marco Milone.

Electronic supplementary material

Appendix 1

. PRISMA flowchart of the include studies. (DOCX 43 kb)

Appendix 2

. NOS quality assessment of the included studies. (DOCX 12 kb)

Supplementary Table 1

Study populations characteristics. (DOCX 16 kb)

Supplementary Figure 1

Funnel plot analysis of a) anastomotic leak, b) 5-year disease freed survival, c) operative time, d) number of harvested nodes, e) wound infection. (PNG 45 kb)

High resolution image (TIF 472 kb)

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Milone, M., Manigrasso, M., Elmore, U. et al. Short- and long-term outcomes after transverse versus extended colectomy for transverse colon cancer. A systematic review and meta-analysis. Int J Colorectal Dis 34, 201–207 (2019). https://doi.org/10.1007/s00384-018-3186-4

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  • DOI: https://doi.org/10.1007/s00384-018-3186-4

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