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Updated: Aug 20, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Best surgical approach for splenic flexure colon cancers: Extended versus segmental resection?
Ilker Ozgur1, David Liska1, Michael A Valente1
1Cleveland Clinic, Digestive Disease and Surgery Institute, Department of Colorectal Surgery, Cleveland, OH, USA.
Background:
The optimal surgical treatment approach for splenic flexure colon cancers remains controversial regarding the type of resection.
Methods:
We hypothesized that both extended and segmental resections have similar surgical and oncologic outcomes. A retrospective review of prospectively collected database was performed on all patients who had colectomy for splenic flexure colon cancer between 1996 and 2018.
Results:
Of 142 patients, 119 underwent extended resection; therefore, this group was compared with the group which underwent segmental resection (n = 23). The groups were similar in age, sex, ASA scores, operative times, estimated blood loss, hospital length of stay, and postoperative complication rates (p > 0.05). Median follow-up was 9.58 years (IQR:5.46-16.48). Multivariable regression models demonstrated no significant association between resection approach and disease-free survival (HR 1.63 [95%CI:0.91-2.92]), as well as overall survival (HR 1.80 [95%CI:0.97; 3.36]).
Conclusion:
In the treatment of splenic flexure colon cancer, segmental colon resections have similar oncologic outcomes when compared to extended colectomies.
