Citation Information :
Almoregy AS, Osman G, Sharafedeen M, Alattar AZ. Laparoscopic Extended Hemicolectomy vs Laparoscopic Transverse Colectomy for Management of Mid-transverse Colon Cancer—Which is the Optimal Surgical Approach?. World J Lap Surg 2021; 14 (3):215-220.
Background: Laparoscopic-assisted surgical approach performing either extended right or left hemicolectomy or performing only conservative approach by transverse colectomy could be considered as various management approaches of cancer of the transverse colon but a consensus of which technique is the best is still lacking. So the choice of surgical approach depends on the preference and experience of the operating surgeon.
Aim: The aim of this study was to compare performing laparoscopic extended right or left hemicolectomy and performing transverse colectomy for management of transverse colon cancer located in the middle part of the transverse colon regarding surgical and oncological findings and patients’ outcomes to prove which surgical approach is the best.
Patients and methods: We analyzed collected data of 120 patients with mid-transverse colon cancer. We divided them into two groups: the first group included 80 patients who were managed by right or left hemicolectomy and the second group included 40 patients who were managed by transverse colectomy. We evaluated operative, postoperative, and follow-up data of all included patients.
Results: The length of specimens was longer in the hemicolectomy group than that in the transverse colectomy group (p = 0.007). The numbers of dissected lymph nodes were significantly higher in the hemicolectomy group than in the transverse colectomy group (p <0.001). The duration of operative time was longer in the hemicolectomy group than in the transverse colectomy group (p = 0.014). The group of patients in the hemicolectomy group experienced a higher rate of recovery findings than the transverse colectomy group. The group of patients in the hemicolectomy group experienced lower rates of intraoperative and perioperative complications than the transverse colectomy group (p = 0.002). Five years of overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) rates were slightly longer in the hemicolectomy groups than those in the transverse colectomy group, but results were not statistically significant.
Conclusion: We concluded that hemicolectomy is a better surgical approach of management of cancer located in the mid-transverse colon regarding operative and short-term outcomes than transverse colectomy, but regarding oncological outcomes, both techniques are considered safe and feasible.
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