Optimal Surgery for Mid‐Transverse Colon Cancer: Laparoscopic Extended Right Hemicolectomy Versus Laparoscopic Transverse Colectomy

Matsuda, Takeru; Sumi, Yasuo; Yamashita, Kimihiro; Hasegawa, Hiroshi; Yamamoto, Masashi; Matsuda, Yoshiko; Kanaji, Shingo; Oshikiri, Taro; Suzuki, Satoshi; Kakeji, Yoshihiro

doi:10.1007/s00268-018-4612-z

Cited by 26 publications

(64 citation statements)

References 34 publications

(29 reference statements)

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“…Imaging the vascular pattern preoperatively via biphasic CT angiography has been shown to be an efficient way of avoiding creating TA B L E 2 Patient factors and tumour characteristics 200 (17) 125 (11) Abbreviations: ASA, American Society of Anesthesiologists physical status classification; EC, extended colectomy; NR, not reported; SC, segmental colectomy.…”

Section: Discussion and Con Clus I Onmentioning

confidence: 99%

“…Segmental colectomy for tumours of the distal transverse colon and splenic flexure was similarly defined as resection of a length of transverse colon and proximal descending colon with ligation of the supplying middle colic vessels at its origin and where required ligation of the left colic vessel[13,14]. Extended colectomy included both left and right extended colectomy[2,5,[10][11][12]14] and sub-total colectomy[13]. All studies were published between 2013 and 2020.Overall a total of 3395 patients were included in the final analysis.Enrolment of patients spanned over29 years (1989-2018).…”

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confidence: 99%

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Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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There is no consensus on the appropriate extent of oncological resection for tumours of the transverse colon. Concerns regarding tumour factors such as pattern of lymph node spread and technical factors such as anastomotic perfusion lead to a variety of procedures being performed. Operations such as sub-total colectomy, extended right hemicolectomy, left hemicolectomy, transverse colectomy and segmental resection are all frequently performed for tumours of similar location [1-5].

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Section: Discussion and Con Clus I Onmentioning

confidence: 99%

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Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

et al. 2020

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“…However, the optimal surgical approach remains unclear for the treatment of transverse colon cancer, and it is often based on the surgeon’s preference whether to perform an extended colectomy or a transverse colectomy. In several retrospective studies for patients with transverse colon cancer, it was [ 15 , 16 ] demonstrated that there were no differences between an extended colectomy and a transverse colectomy in terms of postoperative risk and oncological outcomes, and concluded that a segmental resection may be considered as an option for the treatment of localized tumors of the transverse colon. Theoretically, Toyota et al [ 6 ] found that for 24 patients (45.2%) with lymph node metastasis who were identified among the 53 patients with right-transverse colon cancer, there was no lymph node metastasis at the root of the ileocolic artery.…”

Section: Discussionmentioning

confidence: 99%

The feasibility and safety of complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction in right-transverse colon cancer

et al. 2020

World J Surg Onc

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Background: To evaluate the feasibility and safety of a new surgical method, complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction in right-transverse colon cancer. Methods: We retrospectively analyzed and compared the data of consecutive patients with right-transverse colon cancer who underwent complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction (n = 23) and conventional complete laparoscopic extended right hemicolectomy (n = 34) in our hospital between October 2017 to May 2019, respectively. Results: The overall operation time of the ileocecal junction-preserved group was significantly shorter than that of the control group (p = 0.048). There was no difference in the number of harvested lymph nodes, metastatic lymph nodes, and rate of metastatic lymph nodes (p > 0.05). The ileocecal junction-preserved group showed shorter time of first flatus, lower frequency of postoperative diarrhea, and shorter duration of postoperative hospitalization. Furthermore, it also showed that the defecation frequency was lower in the ileocecal junction-preserved group than the control group on the 1st, 3rd, and 6th month (p < 0.05), and the number of patients who defecated at night or defecated four times or more a day was less in the ileocecal junction-preserved group than control group on the 1st month (p < 0.05). Conclusion: The complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction promises as a safe and feasible surgical procedure for right-transverse colon cancer, associated with earlier recovery of bowel function, shorter operation time, and similar pathological outcomes when compared to the conventional laparoscopic procedure.

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“…The postoperative bowel function has been studied in some studies. Matsuda et al noted that the time to first flatus (median: 2 days) and time to resumption of liquid diet (median: 4 days) was similar in both the treatment arms 15 . Similarly, Leijssen et al found that postoperative ileus developed in 12.5% patients in both the groups 14 …”

Section: Literature Reviewmentioning

confidence: 92%

Surgical management of adenocarcinoma of the transverse colon: What should be the extent of resection?

Roy

Kumar

2020

Annals of Gastroent Surgery

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Transverse colon, owing its origin to midgut and hindgut and harbouring a flexure at both ends, continues to pose a surgical challenge. When compared to the rest of the colon, transverse colon adenocarcinoma is relatively uncommon. These cancers usually present late and lie in close proximity to the stomach, omentum, and pancreas. Adequate lymphadenectomy entails dissection around and ligation of the middle colic vessels. Hence, resectional surgery for transverse colon carcinoma is considered difficult. This is more so because of the variation of arterial and venous anatomy. From this perspective, the surgeon is tempted to perform a more radical operation like extended right or left hemicolectomy to secure an adequate lymphadenectomy. Such a cancer has also been dealt with a more limited transverse colectomy with colo‐colic anastomosis. For all these reasons, patients with transverse colon adenocarcinoma were excluded from randomised trials which compared laparoscopic resection with traditional open operation. Surgical literature is yet to establish a definite operation for transverse colon cancer and the exact procedure is often dictated by surgeon's preference. This is primarily because this is an uncommon cancer. The rapid adoption of laparoscopic operation favoured extended colectomy as transverse colectomy can be difficult by minimally invasive technique. However, in the recent past, cohort studies and meta‐analyses have shown equivalent oncological outcome between transverse colectomy and extended colectomy. It is time to resurrect transverse colectomy and consider it equivalent to its radical counterpart for cancers around the mid‐transverse colon.

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Optimal Surgery for Mid‐Transverse Colon Cancer: Laparoscopic Extended Right Hemicolectomy Versus Laparoscopic Transverse Colectomy

Abstract: Laparoscopic extended right hemicolectomy and laparoscopic transverse colectomy offer similar oncological outcomes for mid-transverse colon cancer. Laparoscopic extended right hemicolectomy might be associated with fewer postoperative complications.

Cited by 26 publications

References 34 publications

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

Segmental versus extended colectomy for tumours of the transverse colon: a systematic review and meta‐analysis

The feasibility and safety of complete laparoscopic extended right hemicolectomy with preservation of the ileocecal junction in right-transverse colon cancer

Surgical management of adenocarcinoma of the transverse colon: What should be the extent of resection?

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