title: Laparoscopic colonic resection for splenic flexure cancer: our experience.
abstract: BACKGROUND
  The treatment of colon cancer located in splenic flexure is not standardized. Laparoscopic approach is still considered a challenging procedure. This study reviews two Institutions experience in laparoscopic treatment of left colonic flexure cancer. Intraoperative, pathologic and postoperative data from patients undergoing laparoscopic splenic flexure resection were analyzed to assess oncological safety as well as early and medium-term outcomes.
  
  
  METHODS
  From October 2005 to May 2014 laparoscopic splenic flexure resection was performed in 23 patients.
  
  
  RESULTS
  Conversion rate was nihil. In 7 cases the anastomosis was performed intracorporeally. Specimen mean length was 21.2 cm, while the distance of distal and proximal resection margin from tumor site was 6.5 and 11.5 respectively. The mean number of harvested lymph nodes was 20.8. Mean operative time was 190 min and mean estimated blood loss was equal to 55 ml. As regard major postoperative complications, one case of postoperative acute pancreatitis and one case of postoperative bleeding from the anastomotic suture line were reported.
  
  
  CONCLUSIONS
  Although our experience is limited and appropriate indications must be set by future randomized studies, we believe that laparoscopic resection with intracorporeal anastomosis appears feasible and safe for patients affected by splenic flexure cancer.
authors.affiliation: Department of General Surgery II, Ospedale San Paolo, University of Milan, Milan, Italy. andreapisaniceretti@yahoo.it.|Ospedale San Paolo, via Di Rudinì 8, 20142, Milano, Italy. andreapisaniceretti@yahoo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pisani Ceretti
authors.affiliation: Department of General Surgery II, Ospedale San Paolo, University of Milan, Milan, Italy. nirvana.maroni@yahoo.it.
authors.forename: Nirvana
authors.initials: N
authors.lastname: Maroni
authors.affiliation: Department of General Surgery, Istituto Clinico Humanitas, IRCCS, University of Milan, Milan, Italy. matteo.sacchi@humanitas.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Sacchi
authors.affiliation: Department of General Surgery, Istituto Clinico Humanitas, IRCCS, University of Milan, Milan, Italy. stefano.bona@humanitas.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bona
authors.affiliation: Department of General Surgery II, Ospedale San Paolo, University of Milan, Milan, Italy. rakele86@gmail.com.
authors.forename: Maria Rachele
authors.initials: MR
authors.lastname: Angiolini
authors.affiliation: Department of General Surgery, Istituto Europeo di Oncologia, University of Milano, Milan, Italy. paolopietro.bianchi@fastwebnet.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bianchi
authors.affiliation: Department of General Surgery II, Ospedale San Paolo, University of Milan, Milan, Italy. enrico.opocher@unimi.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Opocher
authors.affiliation: Department of General Surgery, Istituto Clinico Humanitas, IRCCS, University of Milan, Milan, Italy. marco.montorsi@unimi.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Montorsi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D044684:Colon, Transverse / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome