title: Colon cancer in the splenic flexure: comparison of short-term outcomes of laparoscopic and open colectomy.
abstract: BACKGROUND
  Laparoscopic surgery for colon cancer in the splenic flexure (SF cancer) is technically demanding and has not been evaluated in randomized clinical trials. This study aimed to evaluate the safety and feasibility of laparoscopic surgery for SF cancer.
  
  
  METHODS
  Thirty-three patients undergoing laparoscopic surgery for SF cancer (LAC group) were retrospectively compared with 22 patients undergoing open surgery for SF cancer (OC group) between April 2003 and June 2010.
  
  
  RESULTS
  Left hemicolectomy was the most performed procedure in both groups (79% vs. 82%). Median operating time was significantly longer (209 vs. 178 min) and estimated blood loss was significantly lower (15 vs. 113 mL) in the LAC group than in the OC group. Conversion to open surgery was needed for 1 (3%) patient because of bleeding near the pancreas. Tumor stage was more advanced in the OC group than in the LAC group, but N stages were similar between groups. The median number of lymph nodes harvested was significantly higher in the LAC group than in the OC group (16 vs. 12). The rate of postoperative complications was significantly lower in the LAC group than in the OC group (6% vs. 36%). Time to flatus (1 vs. 3 d), time to liquid diet (2 vs. 5 d), and hospital stay (12 vs. 16 d) were significantly shorter in the LAC group than in the OC group.
  
  
  CONCLUSIONS
  Laparoscopic surgery for SF cancer is feasible.
authors.affiliation: Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiyoshi
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fukunaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagayama
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.forename: Rota
authors.initials: R
authors.lastname: Noaki
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamakawa
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nagasue
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kuroyanagi
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D044684:Colon, Transverse / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome