Laparoscopic segmental left colectomy for splenic flexure carcinoma: a single institution experience

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Debate exists regarding optimal surgical treatment for splenic flexure cancer, including extent of colon resection and lymph node dissection.
• Laparoscopic approaches are increasingly utilized, necessitating evaluation of their efficacy and outcomes.

Purpose of the Study:

• To review institutional experience with laparoscopic treatment of splenic flexure cancer.
• To compare outcomes with existing literature and evaluate long-term results.

Main Methods:

• Retrospective analysis of prospectively maintained data from 28 consecutive patients undergoing laparoscopic segmental left colectomy for splenic flexure colon carcinoma.
• Exclusion of patients with prior colorectal cancer, recurrent disease, emergency presentations, synchronous cancers, or palliative surgery.
• Standardized follow-up for up to 5 years to assess technical, functional, and oncological outcomes.

Main Results:

• A total of 28 patients (median age 71.8 years) were included, with 90-day mortality of 3.5% and surgical morbidity of 21.5%.
• Anastomotic leak rate was 10.7%; however, survivors reported good functional results.
• During a median follow-up of 50.9 months, 28.5% experienced recurrence, with 5-year overall and disease-free survival rates of 46.3% and 39.2%, respectively.

Conclusions:

• Laparoscopic segmental left colectomy for splenic flexure carcinoma demonstrates acceptable morbidity and excellent functional recovery.
• The study highlights a significant challenge with low long-term survival rates, indicating a need for improved oncological strategies.