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, 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

Risultato della ricerca: Articlepeer review

4 Citazioni (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.
Lingua originaleEnglish
Numero di pagine12
RivistaSurgical Endoscopy
Stato di pubblicazionePublished - 2020

All Science Journal Classification (ASJC) codes

  • Surgery

Fingerprint Entra nei temi di ricerca di 'Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis'. Insieme formano una fingerprint unica.

Cita questo