Emergency surgery for obstructive splenic flexure colon cancer: results of a multicentric study of the French Surgical Association (AFC)
Management of malignant left-sided colonic obstruction remains challenging and requires a stoma in 40–65% of patients. In those with obstructive splenic flexure colon cancer (OSFCC), a debate still exists regarding the most appropriate surgery. The aim of this muticenter study was to report and comp...
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| Veröffentlicht in: | Updates in Surgery 2022-02, Vol.74 (1), p.107-115 |
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| description | Management of malignant left-sided colonic obstruction remains challenging and requires a stoma in 40–65% of patients. In those with obstructive splenic flexure colon cancer (OSFCC), a debate still exists regarding the most appropriate surgery. The aim of this muticenter study was to report and compare the different surgical procedures in OSFCC patients with a special focus on operative and histological characteristics and survival outcomes including 12-month stoma-free survival. Between 2000 and 2015, 2325 patients were treated for obstructive colon cancer in centers members of the French National Surgical Association (AFC). Among them, 198 underwent surgery for OSFCC and were retrospectively analyzed. Patients with OSFCC and proximal colonic ischemia or perforation were excluded. Four procedures were performed: decompressing stoma (DS, 39%), splenic flexure colectomy (SFC, 39%), subtotal colectomy (STC, 17%,) and left hemicolectomy (LHC, 5%). All patients treated with LHC underwent a Hartmann’s procedure. There was no significant difference between groups for postoperative mortality and morbidity. Hospital stay was significantly longer after DS. The length of the specimen, longitudinal resection margins and number of harvested lymph nodes were significantly higher in the STC group. There was no difference for overall and disease-free survival. Stoma-free survival was significantly lower after LHC (62%) in comparison with the other groups (
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| doi_str_mv | 10.1007/s13304-021-01206-0 |
| format | Article |
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p
< 0.0001). At the end of follow-up, 50% of patients who underwent LHC had a permanent stoma. In OSFCC patients without proximal colonic ischemia or peritonitis, LHC should no longer be recommended due to a high risk of permanent stoma.</description><identifier>ISSN: 2038-131X</identifier><identifier>EISSN: 2038-3312</identifier><identifier>DOI: 10.1007/s13304-021-01206-0</identifier><identifier>PMID: 34813043</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Cancer ; Colectomy ; Colon cancer ; Colon, Transverse - surgery ; Colonic Neoplasms - surgery ; Gastrointestinal diseases ; Health aspects ; Human health and pathology ; Humans ; Intestinal Obstruction - surgery ; Life Sciences ; Medicine ; Medicine & Public Health ; Mortality ; Oncology, Experimental ; Original Article ; Retrospective Studies ; Surgery ; Tissues and Organs</subject><ispartof>Updates in Surgery, 2022-02, Vol.74 (1), p.107-115</ispartof><rights>Italian Society of Surgery (SIC) 2021</rights><rights>2021. Italian Society of Surgery (SIC).</rights><rights>COPYRIGHT 2022 Springer</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-675b936dbf68226c58f39e628ddbf471c7d6f732dbc05800752be40e6708dba63</citedby><cites>FETCH-LOGICAL-c448t-675b936dbf68226c58f39e628ddbf471c7d6f732dbc05800752be40e6708dba63</cites><orcidid>0000-0002-0783-8688 ; 0000-0002-2608-5896</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s13304-021-01206-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s13304-021-01206-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34813043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://normandie-univ.hal.science/hal-03524831$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Labiad, Camélia</creatorcontrib><creatorcontrib>Manceau, Gilles</creatorcontrib><creatorcontrib>Mege, Diane</creatorcontrib><creatorcontrib>Cazelles, Antoine</creatorcontrib><creatorcontrib>Voron, Thibault</creatorcontrib><creatorcontrib>Bridoux, Valérie</creatorcontrib><creatorcontrib>Lakkis, Zaher</creatorcontrib><creatorcontrib>Abdalla, Solafah</creatorcontrib><creatorcontrib>Karoui, Mehdi</creatorcontrib><creatorcontrib>AFC (French Surgical Association) Working Group</creatorcontrib><title>Emergency surgery for obstructive splenic flexure colon cancer: results of a multicentric study of the French Surgical Association (AFC)</title><title>Updates in Surgery</title><addtitle>Updates Surg</addtitle><addtitle>Updates Surg</addtitle><description>Management of malignant left-sided colonic obstruction remains challenging and requires a stoma in 40–65% of patients. In those with obstructive splenic flexure colon cancer (OSFCC), a debate still exists regarding the most appropriate surgery. The aim of this muticenter study was to report and compare the different surgical procedures in OSFCC patients with a special focus on operative and histological characteristics and survival outcomes including 12-month stoma-free survival. Between 2000 and 2015, 2325 patients were treated for obstructive colon cancer in centers members of the French National Surgical Association (AFC). Among them, 198 underwent surgery for OSFCC and were retrospectively analyzed. Patients with OSFCC and proximal colonic ischemia or perforation were excluded. Four procedures were performed: decompressing stoma (DS, 39%), splenic flexure colectomy (SFC, 39%), subtotal colectomy (STC, 17%,) and left hemicolectomy (LHC, 5%). All patients treated with LHC underwent a Hartmann’s procedure. There was no significant difference between groups for postoperative mortality and morbidity. Hospital stay was significantly longer after DS. The length of the specimen, longitudinal resection margins and number of harvested lymph nodes were significantly higher in the STC group. There was no difference for overall and disease-free survival. Stoma-free survival was significantly lower after LHC (62%) in comparison with the other groups (
p
< 0.0001). At the end of follow-up, 50% of patients who underwent LHC had a permanent stoma. In OSFCC patients without proximal colonic ischemia or peritonitis, LHC should no longer be recommended due to a high risk of permanent stoma.</description><subject>Cancer</subject><subject>Colectomy</subject><subject>Colon cancer</subject><subject>Colon, Transverse - surgery</subject><subject>Colonic Neoplasms - surgery</subject><subject>Gastrointestinal diseases</subject><subject>Health aspects</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Intestinal Obstruction - surgery</subject><subject>Life Sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Oncology, Experimental</subject><subject>Original Article</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tissues and Organs</subject><issn>2038-131X</issn><issn>2038-3312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAUtBCIVkv_AAfkY3tI8UfieLmtVl2KtBIHQOJmOc5z11ViL7ZTsf-An43TLD1iS_bTeGbekweh95TcUkLaj4lyTuqKMFoRyoioyCt0yQiXFeeUvT7XlNOfF-gqpUdSFl_P51t0wWtJi5pfoj93I8QH8OaE01SKeMI2RBy6lONksnsCnI4DeGewHeD3FAGbMASPjfYG4iccIU1DTjhYrPFYSmfA51j4KU_9acbzAfAulh4H_K30cEYPeJNSME5nV6yuN7vtzTv0xuohwdX5XqEfu7vv2_tq__Xzl-1mX5m6lrkSbdOtueg7KyRjwjTS8jUIJvsC1S01bS9sy1nfGdLI8lEN66AmIFoi-04LvkI3i-9BD-oY3ajjSQXt1P1mr2aM8IbVktMnWrjXC_cYw68JUlajSwaGQXsIU1JMEFrLhtPZ9nahPugBlPM25KhN2T2MzgQP1hV801IiqKyfBWwRmBhSimBfhqFEzQmrJWFVElbPCZfJVujDeaCpG6F_kfzLsxD4QkjlyZc41WOYoi8f-j_bv1OtsLI</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Labiad, Camélia</creator><creator>Manceau, Gilles</creator><creator>Mege, Diane</creator><creator>Cazelles, Antoine</creator><creator>Voron, Thibault</creator><creator>Bridoux, Valérie</creator><creator>Lakkis, Zaher</creator><creator>Abdalla, Solafah</creator><creator>Karoui, Mehdi</creator><general>Springer International Publishing</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IAO</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-0783-8688</orcidid><orcidid>https://orcid.org/0000-0002-2608-5896</orcidid></search><sort><creationdate>20220201</creationdate><title>Emergency surgery for obstructive splenic flexure colon cancer: results of a multicentric study of the French Surgical Association (AFC)</title><author>Labiad, Camélia ; 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In those with obstructive splenic flexure colon cancer (OSFCC), a debate still exists regarding the most appropriate surgery. The aim of this muticenter study was to report and compare the different surgical procedures in OSFCC patients with a special focus on operative and histological characteristics and survival outcomes including 12-month stoma-free survival. Between 2000 and 2015, 2325 patients were treated for obstructive colon cancer in centers members of the French National Surgical Association (AFC). Among them, 198 underwent surgery for OSFCC and were retrospectively analyzed. Patients with OSFCC and proximal colonic ischemia or perforation were excluded. Four procedures were performed: decompressing stoma (DS, 39%), splenic flexure colectomy (SFC, 39%), subtotal colectomy (STC, 17%,) and left hemicolectomy (LHC, 5%). All patients treated with LHC underwent a Hartmann’s procedure. There was no significant difference between groups for postoperative mortality and morbidity. Hospital stay was significantly longer after DS. The length of the specimen, longitudinal resection margins and number of harvested lymph nodes were significantly higher in the STC group. There was no difference for overall and disease-free survival. Stoma-free survival was significantly lower after LHC (62%) in comparison with the other groups (
p
< 0.0001). At the end of follow-up, 50% of patients who underwent LHC had a permanent stoma. In OSFCC patients without proximal colonic ischemia or peritonitis, LHC should no longer be recommended due to a high risk of permanent stoma.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34813043</pmid><doi>10.1007/s13304-021-01206-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0783-8688</orcidid><orcidid>https://orcid.org/0000-0002-2608-5896</orcidid></addata></record> |
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| ispartof | Updates in Surgery, 2022-02, Vol.74 (1), p.107-115 |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Cancer Colectomy Colon cancer Colon, Transverse - surgery Colonic Neoplasms - surgery Gastrointestinal diseases Health aspects Human health and pathology Humans Intestinal Obstruction - surgery Life Sciences Medicine Medicine & Public Health Mortality Oncology, Experimental Original Article Retrospective Studies Surgery Tissues and Organs |
| title | Emergency surgery for obstructive splenic flexure colon cancer: results of a multicentric study of the French Surgical Association (AFC) |
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