Splenic Flexure Cancer- is right extended hemicolectomy better than left hemicolectomy?

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 ³3a 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 DFS 71.8% Vs 67.8% p = 0.877 and 3-year OS 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.