Retrospective analysis of a single institute's experience of transverse colectomy vs extended colectomy for the management of mid‐transverse colon cancer

• Published in: Surgical practice Vol. 25; no. 2; pp. 69 - 77
• Main Authors: Chow, Tom Chi‐man, Wong, Chi‐keung, Si, Alvin Lok‐ping, Ng, Andrew Sheung‐hey, Kong, Chi‐kwan
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01.05.2021; Blackwell Publishing Ltd
• Subjects: colectomy; colon cancer; Colorectal cancer; Colorectal surgery; retrospective study; Surgical outcomes; survival rate; transverse colon
• ISSN: 1744-1625; 1744-1633
• DOI: 10.1111/1744-1633.12487

Objective Mid‐transverse colon cancers are uncommon. The optimum operative strategy, whether extended colectomy or limited transverse colectomy, is not well established. Herein we share our local experience. Methodology Consecutive patients with mid‐transverse colon cancer resection from January 2000 to January 2020 were identified from electronic records. Short‐ and long‐term outcomes were analyzed. Additional propensity‐score matching adjusted for potential treatment selection bias. Results A total of 107 patients were analyzed. 23 patients (21.5%) underwent transverse colectomy (TC) and 84 (78.5%) underwent extended colectomy (EC) of which 68 were extended right hemicolectomy. 53% of all operations were laparoscopic. Similar postoperative complication rate, postoperative length of stay and 30 day mortality rate were found. Although fewer lymph node (median 11 vs 19, P < .01) and shorter closest axial margin (3.8 vs 5.5 cm, P < .01) were achieved in the TC group, similar 5‐years overall survival, and 1‐year disease‐free survival were found. Subgroup analysis revealed a trend of poorer survival amongst stage III/IV patients with transverse colectomy. Conclusions Our study verifies the feasibility and safety of transverse colectomy for mid‐transverse colon cancers. Attention should focus on achieving adequate margin length and nodal yield.