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Journal of the Korean Society of Coloproctology 2007;23(3):167-171.
DOI: https://doi.org/10.3393/jksc.2007.23.3.167   
Laparoscopic Surgery for Splenic Flexure Colon Cancer.
Lee, Yoon Suk , Heo, Yoon Jung , Lee, In Kyu , Cho, Hyun Min , Kang, Won Kyung , Park, Jong Kyung , Ahn, Chang Hyuk , Lee, Do Sang , Oh, Seung Teak , Kim, Jun Gi , Kim, Young Ha
1Division of Coloproctology, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2Department of Surgery, Our Lady of Merry Hospital, 665, Bupyeong 6-dong, Bupyeong-gu, Incheo, Korea. yslee@catholic.ac.kr
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.
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.
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.
A laparoscopic left colectomy for splenic flexure colon cancer is a technically feasible and safe procedure with acceptable short-term outcomes in experienced hands.
Key Words: Laparoscopy; Splenic flexure colon cancer


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