Laparoscopic Surgery for Splenic Flexure Colon Cancer.
10.3393/jksc.2007.23.3.167
- Author:
Yoon Suk LEE
1
;
Yoon Jung HEO
;
In Kyu LEE
;
Hyun Min CHO
;
Won Kyung KANG
;
Jong Kyung PARK
;
Chang Hyuk AHN
;
Do Sang LEE
;
Seung Teak OH
;
Jun Gi KIM
;
Young Ha KIM
Author Information
1. Division of Coloproctology, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Splenic flexure colon cancer
- MeSH:
Female;
Male;
Humans;
Mortality
- From:Journal of the Korean Society of Coloproctology
2007;23(3):167-171
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: While a carcinoma of the splenic flexure is uncommon, is associated with a high risk of obstruction, and has a dual lymphatic drainage system, A COST study excluded transverse colon cancer, including splenic flexure colon cancer. This study reviews our experience with splenic flexure colon cancer treated laparoscopically and discusses a appropriate, safe laparoscopic surgical procedure. Methods: The authors reviewed the medical records of patients who underwent laparoscopic surgery for splenic flexure colon cancer from January 1995 to June 2006. The splenic flexure colon was defined as 5 cm from the splenic flexure proximally and distally by using radiologic studies. Curative surgery for splenic flexure colon cancer was defined as: primary cancer removal, a safe resected margin, no metastasis, and a complete lymphadenectomy including high ligation of left colic artery and of the left branch of the middle colic artery. Results: A total of 407 patients underwent laparoscopic surgery for colon cancer; among them, 15 patients underwent a laparoscopic left colectomy for splenic flexure colon cancer. The mean age of the patients was 63.8 years, and the male-to-female ratio was 9:6. The mean operation time was 325.3+/-95.1 minutes, and the average hospital stay was 15.8+/-4.9 days. The average number of harvested lymph nodes was 12.3+/-9.7, the average distal resection margin was 15.3+/-7.6 cm, and the average proximal margin was 10.7+/-3.2 cm. One case of chyle discharge and one case of ileus developed, but were treated conservatively. There was no surgical mortality. Conclusions: A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.