1. Subtotal colectomy versus left hemicolectomy for the elective treatment of splenic flexure colonic neoplasia
- Author
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Laura Mora, Sebastiano Biondo, Francesc Vallribera, Albert García, Jaime Lopez-Borao, Ramon Farrés, Julia Audije Gil, Eloy Espin, and Marc Beisani
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Internal medicine ,Epidemiology ,medicine ,Humans ,Surgical treatment ,Colectomy ,Aged ,Retrospective Studies ,Splenic flexure ,Aged, 80 and over ,Subtotal Colectomy ,business.industry ,General Medicine ,Length of Stay ,Middle Aged ,Methods observational ,Surgical morbidity ,Survival Rate ,Treatment Outcome ,Elective Surgical Procedures ,Spain ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,030211 gastroenterology & hepatology ,Surgery ,Left hemicolectomy ,Female ,Laparoscopy ,Morbidity ,business ,Hospital stay ,Colon, Transverse ,Follow-Up Studies - Abstract
Background Optimal elective surgical treatment for splenic flexure neoplasm (SFN) is unclear. Subtotal colectomy (STC) and left hemicolectomy (LHC) are the two more common strategies used. Methods Observational multicentric study comparing postoperative morbidity, mortality and long-term survival on patients with SFN electively operated by STC versus LHC between 2003 and 2014. Results After revision of the databases, 144 patients were included (STC group, n = 68; LHC group, n = 76). No differences were found on epidemiological and surgical data. A higher global morbidity (58%vs37%, p = 0.014), surgical morbidity (50%vs33%, p = 0.037), postoperative ileus (37%vs20%, p = 0.023) and harvested lymph nodes (26vs18, p = 0.0001) were found on the STC group. No significant differences in complications according to severity, reoperation rate, hospital stay, mortality, recurrence or long-term survival were found between groups. Conclusions A higher surgical morbidity was found on the STC group, mainly due to mild postoperative ileus. No differences on long-term oncological results were found.
- Published
- 2017