title: Laparoscopic resection with intracorporeal anastomosis for colon carcinoma located in the splenic flexure.
abstract: BACKGROUND
  Treatment of splenic flexure (SF) colon cancer is not standardized. A laparoscopic approach is considered a challenging procedure.
  
  
  METHODS
  This review examines a single-institution experience with laparoscopic colon resection for cancer of the SF. Intraoperative, pathologic, and postoperative data of patients who underwent laparoscopic SF resection were reviewed to assess for oncologic safety as well as early- and medium-term outcomes.
  
  
  RESULTS
  Between September 2004 and January 2009, laparoscopic SF resection was performed for 15 patients with SF. Two cases of conversion were reported, and for three patients, colonic resection was robot assisted. In all cases, the anastomosis was completed intracorporeally. The distal margin was 3.8 +/- 2.5 cm, and the proximal margin was 7.8 +/- 3.7 cm from the tumor site. The mean number of harvested nodes was 9.2 +/- 5.3. The mean operative time was 183.6 +/- 45 min, and the blood loss was 98 +/- 33 ml. No major morbidity was recorded.
  
  
  CONCLUSIONS
  Laparoscopic partial resection seems to be feasible and safe for the treatment of early-stage and locally advanced SF cancer.
authors.affiliation: Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, Hospital San Matteo degli Infermi, Via Loreto, 3, 06049, Spoleto, PG, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Ceccarelli
authors.forename: Alessia
authors.initials: A
authors.lastname: Biancafarina
authors.forename: Alberto
authors.initials: A
authors.lastname: Patriti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Spaziani
authors.forename: Alberto
authors.initials: A
authors.lastname: Bartoli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bellochi
authors.forename: Massimo Codacci
authors.initials: MC
authors.lastname: Pisanelli
authors.forename: Luciano
authors.initials: L
authors.lastname: Casciola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012371:Robotics; D017792:Surgical Stapling