Emergency surgery for splenic flexure cancer : results of the SFC Study Group database
de'Angelis, Nicola (General Regional Hospital F. Miulli)
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron)
Ris, Frederic (Geneva University Hospitals (Suïssa))
Landi, Filippo (Hospital de Viladecans)
Le Roy, Bertrand (CHU Clermont-Ferrand)
Coccolini, Federico (Bufalini Hospital)
Celentano, Valerio (University of Portsmouth)
Gurrado, Angela (University of Bari "Aldo Moro" Medical School)
Pezet, Denis (CHU Clermont-Ferrand)
Bianchi, Giorgio (General Regional Hospital F. Miulli)
Memeo, Riccardo (General Regional Hospital F. Miulli)
Vitali, Giulio C. (Geneva University Hospitals (Suïssa))
Solis, Alejandro (Hospital Universitari Vall d'Hebron)
Denet, Christine (Paris Descartes University)
Di Saverio, Salomone (Cambridge Biomedical Campus)
de'Angelis, Gian Luigi (University of Parma)
Kraft, Miquel (Hospital Universitari Vall d'Hebron)
Gonzálvez-Guardiola, Paula (Hospital Universitari Doctor Peset (València))
Stakelum, Aine (St Vincent's Hospital (Sydney))
Catena, Fausto (University Hospital of Parma)
Fuks, David (Paris Descartes University)
Winter, Des C. (St Vincent's Hospital (Sydney))
Testini, Mario (University of Bari "Aldo Moro" Medical School)
Martínez-Pérez, Aleix (General Regional Hospital F. Miulli)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	The effectiveness of surgical treatment for splenic flexure carcinomas (SFCs) in emergency settings remains unexplored. This study aims to compare the perioperative and long-term outcomes of different alternatives for emergency SFC resection. This multicenter retrospective study was based on the SFC Study Group database. For the present analysis, SFC patients were selected if they had received emergency surgical resection with curative intent between 2000 and 2018. Extended right colectomy (ERC), left colectomy (LC), and segmental left colectomy (SLC) were evaluated and compared. The study sample was composed of 90 SFC patients who underwent emergency ERC (n = 55, 61. 1%), LC (n = 18, 20%), or SLC (n = 17, 18. 9%). Bowel obstruction was the most frequent indication for surgery (n = 75, 83. 3%), and an open approach was chosen in 81. 1% of the patients. A higher incidence of postoperative complications was observed in the ERC group (70. 9%) than in the LC (44. 4%) and SLC groups (47. 1%), with a significant procedure-related difference for severe postoperative complications (Dindo-Clavien ≥ III; adjusted odds ratio for ERC vs. LC:7. 23; 95% CI 1. 51-34. 66; p = 0. 013). Anastomotic leakage occurred in 8 (11. 2%) patients, with no differences between the groups (p = 0. 902). R0 resection was achieved in 98. 9% of the procedures, and ≥ 12 lymph nodes were retrieved in 92. 2% of patients. Overall and disease-free survival rates at 5 years were similar between the groups and were significantly associated with stage pT4 and the presence of synchronous metastases. In the emergency setting, ERC and open surgery are the most frequently performed procedures. ERC is associated with increased odds of severe postoperative complications when compared to more conservative SFC resections. Nonetheless, all the alternatives seem to provide similar pathologic and long-term outcomes, supporting the oncological safety of more conservative resections for emergency SFCs.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Splenic flexure carcinoma ; Emergency surgery ; Mortality ; Survival ; Colectomy ; Cancer
Published in:	World Journal of Emergency Surgery : WJES, Vol. 16 (april 2021) , ISSN 1749-7922

DOI: 10.1186/s13017-021-00365-0
PMID: 33926504

10 p, 1.0 MB

The record appears in these collections:
Articles > Research articles
Articles > Published articles