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KMID : 0356720070230030167
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Journal of the Korean Society of Coloproctology
2007 Volume.23 No. 3 p.167 ~ p.171
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Laparoscopic Surgery for Splenic Flexure Colon Cancer
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Lee Yoon-Suk
Heo Yoon-Jung
Lee In-Kyu
Cho Hyun-Min
Kang Won-Kyung
Park Jong-Kyung
An Chang-Hyeok
Lee Do-Sang
Oh Seung-Tack
Kim Jun-Gi
Kim Young-Ha
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Abstract
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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. J Korean Soc Coloproctol 2007;23: 167-171
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KEYWORD
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Laparoscopy, Splenic flexure colon cancer
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