TY - JOUR
T1 - Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis
AU - Genova, Pietro
AU - Di Saverio, Salomone
AU - Sobhani, Iradj
AU - Espin, Eloy
AU - Assalino, Michela
AU - Fuks, David
AU - Coccolini, Federico
AU - Winter, Des C.
AU - Celentano, Valerio
AU - Vitali, Giulio Cesare
AU - Landi, Filippo
AU - Ansaloni, Luca
AU - Sueiras-Gil, Albert
AU - Gómez, Segundo A.
AU - Martínez-Pérez, Aleix
AU - Le Roy, Bertrand
AU - Zaborowski, Alexandra
AU - Winter, Des C.
AU - Birindelli, Arianna
AU - Solis, Alejandro
AU - Genova, Pietro
AU - De’Angelis, Nicola
AU - De’Angelis, Nicola
AU - Bianchi, Giorgio
AU - Kraft, Miquel
AU - Ris, Frederic
AU - Stakelum, Aine
AU - Pham, Julie
AU - Payá, Carmen
AU - Abdallah, Mourad
AU - Hevia, Ramiro
AU - Torres, M. Teresa
AU - Gonzálvez, Paula
AU - De’Angelis, Nicola
AU - Hevia, Ramiro
AU - Torres, M. Teresa
AU - Denet, Christine
AU - Brunetti, Francesco
AU - Pezet, Denis
PY - 2020
Y1 - 2020
N2 - Background: The surgical resection of the splenic flexure carcinoma (SFC) is challenging and the optimal surgical procedure for SFCs remains a matter of debate. The present study aimed to compare in a multicenter European sample of patients the short- and long-term outcomes of extended right (ERC) vs. left (LC) vs. segmental left colectomy (SLC) for SFCs. Methods: This retrospective multicenter study analyzed the surgical and oncological outcomes of SFC patients undergoing elective curative intent surgery between 2000 and 2018. Descriptive and exploratory analyses were first conducted on the whole sample. Outcomes of the different procedures (ERC vs. LC vs. SLC) were then compared using propensity score matching for multilevel treatment. Overall (OS) and disease-free survival (DFS) were evaluated by Kaplan–Meier method. Results: From a total of 399 SFC patients, 143 (35.8%) underwent ERC, 131 (32.8%) underwent LC, and 125 (31.4%) underwent SLC. Overall, 297 (74.4%) were laparoscopic procedures. An increase in operative time, time to flatus, time to regular diet, and hospital stay was observed with the progressive extension of SFC resection. ERC was associated with significantly increased risk of postoperative ileus compared to both LC and SLC. A significantly greater number of lymph nodes were retrieved by ERC, but the objective of at least 12 retrieved lymph nodes was achieved in 85% of patients, without procedure-related differences. No differences were observed in OS or DFS between ERC, LC, and SLC. Conclusion: The present study supports the resection of SFCs by colon-sparing surgical techniques, such as SLC.
AB - Background: The surgical resection of the splenic flexure carcinoma (SFC) is challenging and the optimal surgical procedure for SFCs remains a matter of debate. The present study aimed to compare in a multicenter European sample of patients the short- and long-term outcomes of extended right (ERC) vs. left (LC) vs. segmental left colectomy (SLC) for SFCs. Methods: This retrospective multicenter study analyzed the surgical and oncological outcomes of SFC patients undergoing elective curative intent surgery between 2000 and 2018. Descriptive and exploratory analyses were first conducted on the whole sample. Outcomes of the different procedures (ERC vs. LC vs. SLC) were then compared using propensity score matching for multilevel treatment. Overall (OS) and disease-free survival (DFS) were evaluated by Kaplan–Meier method. Results: From a total of 399 SFC patients, 143 (35.8%) underwent ERC, 131 (32.8%) underwent LC, and 125 (31.4%) underwent SLC. Overall, 297 (74.4%) were laparoscopic procedures. An increase in operative time, time to flatus, time to regular diet, and hospital stay was observed with the progressive extension of SFC resection. ERC was associated with significantly increased risk of postoperative ileus compared to both LC and SLC. A significantly greater number of lymph nodes were retrieved by ERC, but the objective of at least 12 retrieved lymph nodes was achieved in 85% of patients, without procedure-related differences. No differences were observed in OS or DFS between ERC, LC, and SLC. Conclusion: The present study supports the resection of SFCs by colon-sparing surgical techniques, such as SLC.
KW - Extended right colectomy
KW - Left colectomy
KW - Postoperative complications
KW - Propensity score matching
KW - Segmental left colectomy
KW - Splenic flexure carcinoma
KW - Extended right colectomy
KW - Left colectomy
KW - Postoperative complications
KW - Propensity score matching
KW - Segmental left colectomy
KW - Splenic flexure carcinoma
UR - http://hdl.handle.net/10447/414401
M3 - Article
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
ER -