Medicine · 4 authors, 1 centre
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This meta-analysis of 15 studies compared surgical techniques for splenic flexure colon cancer. Laparoscopic surgery showed significant short-term benefits over open surgery, while extended right colectomy harvested more lymph nodes than left colectomy.
Laparoscopic versus open surgery was analyzed for short-term outcomes, and extended right colectomy (ERC) versus left colectomy (LC) was analyzed for oncological and postoperative outcomes using a random-effect model. Laparoscopic surgery was associated with significantly shorter hospital stay, less intraoperative blood loss, fewer postoperative complications, and earlier time to oral diet compared to open surgery. No significant differences were found in operation time, anastomotic leakage, or surgical site infection. For the comparison of ERC versus LC, ERC resulted in a significantly higher number of harvested lymph nodes. No significant differences were noted for other parameters, including operation time, R0 resection, reoperation, anastomotic leakage, mortality, inpatient time, or postoperative complications. Neoadjuvant therapy showed a beneficial impact on overall survival. Limitations include the rarity of the disease and technical challenges of laparoscopic procedures for this location. The findings support the use of laparoscopic techniques for improved short-term recovery and suggest ERC may offer a lymph node yield advantage.
