Short And Long Term Outcomes After Surgical Resection Of Tumours Of The Splenic Flexure – A Two Institutions’ Experience

Published Date: 17th January 2023

Publication Authors: Rajendiran A

Background
This study was conducted as a part of our service evaluation of colorectal resections. Our primary outcomes were 30 day mortality, 90 day mortality, complication rate and recurrence rates at 3 and 5 years. The secondary outcomes were lymph node harvest >12 and length of stay.

Methodology
Retrospective data collection from a prospectively maintained database across two trusts over a period of 7 years (2015 - 2021). Tumors with site recorded as splenic flexure, distal transverse and proximal descending were included. Our team comprised of 30 colorectal surgeons with comparable level of experience. Data collected was processed using SPSS ver 23.

Results
69 patients were included in the study. 82.6% presented with symptoms and 14.5% were from the asymptomatic screening pathway. 95.6% (66/69) were curative resections and 4.4% (3/69) were palliative. 85.5% of the patients had extended right hemicolectomy, 10.1 % had left hemicolectomy and 2.9 % had segmental colectomy. Out of the curative resections, 30 day mortality was 4.3% and 90 day mortality was 5.7%. 72.4% of the tumours were Duke's stage B and C1, 72.5% showed moderate differentiation. 88.4% of patients had > 12 lymph nodes harvested and 26% had harvest >25. Details regarding resection margins were available for 41/69 and 40 were R0 resections. 5.8% of patients had post op leak and 8.7% had chest complications. Median length of stay was 10 days. Recurrence rate was 2.9% at 3 years and 5.8% at 5 years.

Conclusion
We identified agreement in an area of medicine that has a long history of controversy and varied practice. None of the areas of consensus are based on high-quality evidence. This document is thus a framework to guide clinical practice and on which high-quality clinical trials can be developed.

 

Rajendiran, A; Dorra, A; Abdalla, A; Ahmed, R; Hussain, A. (2022). Short And Long Term Outcomes After Surgical Resection Of Tumours Of The Splenic Flexure – A Two Institutions’ Experience. European Journal of Surgical Oncology. 49(1), p.E9. [Online]. Available at: https://doi.org/10.1016/j.ejso.2022.11.057 [Accessed 23 February 2023]

 

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