Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis

Pietro Genova; Salomone Di Saverio; Iradj Sobhani; Eloy Espin; Michela Assalino; David Fuks; Federico Coccolini; Valerio Celentano; Giulio Cesare Vitali; Filippo Landi; Luca Ansaloni; Albert Sueiras-Gil; Segundo A. Gómez; Aleix Martínez-Pérez; Bertrand Le Roy; Alexandra Zaborowski; Des C. Winter; Arianna Birindelli; Alejandro Solis; Pietro Genova; Nicola De’Angelis; Nicola De’Angelis; Giorgio Bianchi; Miquel Kraft; Frederic Ris; Aine Stakelum; Julie Pham; Carmen Payá; Mourad Abdallah; Ramiro Hevia; M. Teresa Torres; Paula Gonzálvez; Nicola De’Angelis; Christine Denet; Francesco Brunetti; Denis Pezet

Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis

Pietro Genova, Salomone Di Saverio, Iradj Sobhani, Eloy Espin, Michela Assalino, David Fuks, Federico Coccolini, Valerio Celentano, Giulio Cesare Vitali, Filippo Landi, Luca Ansaloni, Albert Sueiras-Gil, Segundo A. Gómez, Aleix Martínez-Pérez, Bertrand Le Roy, Alexandra Zaborowski, Des C. Winter, Arianna Birindelli, Alejandro Solis, Pietro GenovaNicola De’Angelis, Nicola De’Angelis, Giorgio Bianchi, Miquel Kraft, Frederic Ris, Aine Stakelum, Julie Pham, Carmen Payá, Mourad Abdallah, Ramiro Hevia, M. Teresa Torres, Paula Gonzálvez, Nicola De’Angelis, Christine Denet, Francesco Brunetti, Denis Pezet

Discipline Chirurgiche, Oncologiche e Stomatologiche

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

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.

Original language	English
Number of pages	12
Journal	Surgical Endoscopy
Publication status	Published - 2020

All Science Journal Classification (ASJC) codes

Surgery

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Genova, P., Di Saverio, S., Sobhani, I., Espin, E., Assalino, M., Fuks, D., Coccolini, F., Celentano, V., Vitali, G. C., Landi, F., Ansaloni, L., Sueiras-Gil, A., Gómez, S. A., Martínez-Pérez, A., Le Roy, B., Zaborowski, A., Winter, D. C., Birindelli, A., Solis, A., ... Pezet, D. (2020). Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. Surgical Endoscopy.

Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. / Genova, Pietro; Di Saverio, Salomone; Sobhani, Iradj; Espin, Eloy; Assalino, Michela; Fuks, David; Coccolini, Federico; Celentano, Valerio; Vitali, Giulio Cesare; Landi, Filippo; Ansaloni, Luca; Sueiras-Gil, Albert; Gómez, Segundo A.; Martínez-Pérez, Aleix; Le Roy, Bertrand; Zaborowski, Alexandra; Winter, Des C.; Birindelli, Arianna; Solis, Alejandro; Genova, Pietro; De’Angelis, Nicola; De’Angelis, Nicola; Bianchi, Giorgio; Kraft, Miquel; Ris, Frederic; Stakelum, Aine; Pham, Julie; Payá, Carmen; Abdallah, Mourad; Hevia, Ramiro; Torres, M. Teresa; Gonzálvez, Paula; De’Angelis, Nicola; Denet, Christine; Brunetti, Francesco; Pezet, Denis.

In: Surgical Endoscopy, 2020.

Research output: Contribution to journal › Article › peer-review

Genova, P, Di Saverio, S, Sobhani, I, Espin, E, Assalino, M, Fuks, D, Coccolini, F, Celentano, V, Vitali, GC, Landi, F, Ansaloni, L, Sueiras-Gil, A, Gómez, SA, Martínez-Pérez, A, Le Roy, B, Zaborowski, A, Winter, DC, Birindelli, A, Solis, A, Genova, P, De’Angelis, N, De’Angelis, N, Bianchi, G, Kraft, M, Ris, F, Stakelum, A, Pham, J, Payá, C, Abdallah, M, Hevia, R, Torres, MT, Gonzálvez, P, De’Angelis, N, Denet, C, Brunetti, F & Pezet, D 2020, 'Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis', Surgical Endoscopy.

Genova, Pietro ; Di Saverio, Salomone ; Sobhani, Iradj ; Espin, Eloy ; Assalino, Michela ; Fuks, David ; Coccolini, Federico ; Celentano, Valerio ; Vitali, Giulio Cesare ; Landi, Filippo ; Ansaloni, Luca ; Sueiras-Gil, Albert ; Gómez, Segundo A. ; Martínez-Pérez, Aleix ; Le Roy, Bertrand ; Zaborowski, Alexandra ; Winter, Des C. ; Birindelli, Arianna ; Solis, Alejandro ; Genova, Pietro ; De’Angelis, Nicola ; De’Angelis, Nicola ; Bianchi, Giorgio ; Kraft, Miquel ; Ris, Frederic ; Stakelum, Aine ; Pham, Julie ; Payá, Carmen ; Abdallah, Mourad ; Hevia, Ramiro ; Torres, M. Teresa ; Gonzálvez, Paula ; De’Angelis, Nicola ; Denet, Christine ; Brunetti, Francesco ; Pezet, Denis. / Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis. In: Surgical Endoscopy. 2020.

@article{2bb179cdbfc0462c89ed350a4fc09fc3,

title = "Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis",

abstract = "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.",

keywords = "Extended right colectomy, Left colectomy, Postoperative complications, Propensity score matching, Segmental left colectomy, Splenic flexure carcinoma, Extended right colectomy, Left colectomy, Postoperative complications, Propensity score matching, Segmental left colectomy, Splenic flexure carcinoma",

author = "Pietro Genova and {Di Saverio}, Salomone and Iradj Sobhani and Eloy Espin and Michela Assalino and David Fuks and Federico Coccolini and Valerio Celentano and Vitali, {Giulio Cesare} and Filippo Landi and Luca Ansaloni and Albert Sueiras-Gil and G{\'o}mez, {Segundo A.} and Aleix Mart{\'i}nez-P{\'e}rez and {Le Roy}, Bertrand and Alexandra Zaborowski and Winter, {Des C.} and Arianna Birindelli and Alejandro Solis and Pietro Genova and Nicola De{\textquoteright}Angelis and Nicola De{\textquoteright}Angelis and Giorgio Bianchi and Miquel Kraft and Frederic Ris and Aine Stakelum and Julie Pham and Carmen Pay{\'a} and Mourad Abdallah and Ramiro Hevia and Torres, {M. Teresa} and Paula Gonz{\'a}lvez and Nicola De{\textquoteright}Angelis and Christine Denet and Francesco Brunetti and Denis Pezet",

year = "2020",

language = "English",

journal = "Surgical Endoscopy and Other Interventional Techniques",

issn = "0930-2794",

publisher = "Springer New York",

}

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 - 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 - 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 - 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 -