Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 14;408(1):402.
doi: 10.1007/s00423-023-03135-5.

Splenic flexure cancer: is right extended hemicolectomy better than left hemicolectomy?

Devesh S Ballal  1 , Harsh Mohan Agrawal  1 , Mufaddal Kazi  1 , Ashwin Desouza  1 , Avanish P Saklani  2
Affiliations

Splenic flexure cancer: is right extended hemicolectomy better than left hemicolectomy?

Devesh S Ballal et al. Langenbecks Arch Surg. .

Abstract

Introduction: There is no consensus on the optimal surgery for splenic flexure cancers.

Methods: Review of a prospectively maintained database of patients with splenic flexure cancer undergoing either a right extended hemicolectomy or left hemicolectomy at a tertiary care cancer hospital from 14.5.2010 to 16.9.2021. The primary outcome measures were postoperative morbidity and hospital stay with secondary outcomes being overall survival, disease-free survival, and long-term patient reported functional and quality of life outcomes.

Results: The demographic variables were evenly distributed between groups, and median follow-up was 44 months. The groups were comparable in terms of postoperative morbidity (Clavien-Dindo complication ≥ 3a 10.6% vs 10%, p = 0.322) and hospital stay (8 days vs 7 days, p = 0.316). Oncological outcomes were similar in both groups (3-year disease-free survival 71.8% vs 67.8%, p = 0.877, and 3-year overall survival 83.9% vs 75.8%, p = 0.787), and long-term patient-reported functional outcomes were excellent in both groups.

Conclusion: Oncological outcomes, post operative morbidity, and long-term patient reported functional outcomes are comparable in patients undergoing either a right extended or left hemicolectomy for splenic flexure cancer.

Keywords: Left hemicolectomy; Oncological outcomes; Quality of life; Right extended hemicolectomy; Splenic flexure cancer.

PubMed Disclaimer

References

    1. Phipps AI, Chan AT, Ogino S (2013) Anatomic subsite of primary colorectal cancer and subsequent risk and distribution of second cancers. Cancer 119(17):3140–3147. https://doi.org/10.1002/CNCR.28076 - DOI - PubMed
    1. Martín Arévalo J et al (2018) Propensity score analysis of postoperative and oncological outcomes after surgical treatment for splenic flexure colon cancer. Int J Colorectal Dis 33(9):1201–1213. https://doi.org/10.1007/S00384-018-3063-1 - DOI - PubMed
    1. Chan DS, Shah PR, Soanes M, Saklani A (2013) Current trends and controversies in the management of patients with splenic flexure tumours. J Cancer Res Ther (Manch) 1(1):8–10. https://doi.org/10.14312/2052-4994.2013-2 - DOI
    1. Sadler GP, Gupta R, Foster ME (1992) Carcinoma of the splenic flexure—a case for extended right hemicolectomy? Postgrad Med J 68(800):487. https://doi.org/10.1136/PGMJ.68.800.487 - DOI - PubMed - PMC
    1. Manceau G et al (2022) What is the optimal elective colectomy for splenic flexure cancer: end of the debate? A multicenter study from the GRECCAR group with a propensity score analysis. Dis Colon Rectum 65(1):55–65. https://doi.org/10.1097/DCR.0000000000001937 - DOI - PubMed

LinkOut - more resources