Surgical management of splenic flexure colonic malignancy

Table 2 Summary of comparative studies analyzing the different surgical approaches for splenic flexure malignancy, mean ± SD

Ref.	Study type	Approach evaluated	MIS (%)	EM or EL setting	Operative time (minute)	LOS (days)	Postop mortality (%)	Postoperative morbidity (%)	Anastomotic leak	Reoperation	Ileus	No of LN harvested	Positive LN (%)	OS (%)	DFS (%)
Manceau et al[15]	Retrospective multi- center	SR	40	EL	180 (68-440)	10 (4-175)	2	16	8	10	NA	15 (1-81)	NA	8	82
		LH	44	EL	217 (149-480)	9 (4-55)	2	23	5	5	NA	16 (3-52)	NA	78	72
		STC	71	EL	260 (120-46)1	13 (5-56)1	3	19	11	14	NA	24 (8-90)1	NA	80	72
Odermatt et al[18]	Retrospective single center	LH	20	EM + EL	NA	11 (2-61)	3.3	NA	3.3	6.7	NA	NA	NA	60	54
		ERH	10.5	EM + EL	NA	16.5 (3-79)	7.9	NA	10.5	10.5	NA	NA	NA	49	41
Pang et al[19]	Retrospective multi- center	SR	72.8		193 ± 84.11	5.4 ± 4.5	0.7	8.9	3.7	3.7	NA	19.4 ± 9.8	NA	NA	NA
		LH	71.4	EL	213 ± 83.5	5.3 ± 4.3	0.4	8.4	4	4.8	NA	21.2 ± 12.21	NA	NA	NA
Bono et al[20]	Retrospective multi- center	SR	7	EM + EL	196.2	14.1	7	10.5	7	NA	0	13 5 ± 28	NA	No difference	No difference
		LH	14	EM + EL	215.08	14.03	3.5	14	7	NA	1.8	14.5 ± 7.23	NA
		ERH	8.3	EM + EL	211.11	14.55	0	13.9	13.9	NA	0	19.3 ± 8.01	NA
		TC	0	EM + EL	2351	11.63	4.6	9	0	NA	0	19/7 ± 7.011	NA
Martín Arévalo et al[21]	Retrospective single center	SR	8	EM + EL	152 (85-330)	NA	14	50	5.5	14	NA	17.5 (2-32)	22	87.5	87.5
		LH	9	EM + EL	180 (75-385)	NA	2	43	5	5	NA	15 (2-68)	36.5	95.5	89
		ERH/STC	17	EM + EL	180 (58-360)	NA	7	34	8.5	7	NA	17 (3-60)	38	94	96
Huang et al[22]	Retrospective single center	SR	84.9	EL	239.1 ± 62.1	9.2 ± 5.4	0	27.4	1.	0	6.8	27.5 ± 13.6	3.6	94	88.2
		LH	86.4	EL	222.7 ± 54.9	9.4 ± 4.5	0	22.7	0	0	13.6	25 ± 10.3	8	90.2	90.2
		ELH	86.4	EL	197.1 ± 42.6	8.2 ± 3.8	0	31.8	0	0	9.1	25.6 ± 11.6	4.3	94.1	83.0
Rega et al[24]	Retrospective single center	SR	17.5		105.3 ± 49.6		2	5	NA	NA	NA	21.5 ± 9.6	33	NA	NA
		LH	21		109 ± 50.8		0	4	NA	NA	NA	23.3 ± 13.9	37.5	NA	NA
		STC	14		121 ± 58.6		0	9	NA	NA	NA	28/9 ± 13	21	NA	NA
de’Angelis et al[25]	Retrospective single center	LH	100	EL	192.2 ± 43.4	8.1 ± 1.8	0	22.2	0	NA	7.4	16.6 ± 5.5	NA	75.1	66.7
		ERH	100	EL	235 ± 49.181	8.6 ± 3.4	0	22.2	3.7	NA	0	21.4 ± 4.91	NA	72.8	67.1
Beisani et al[26]	Retrospective multi- center	LH	38	EL	NA	7	5	37	7	9	20	18	11	84	16
		ERH/STC	32	EL	NA	10	6	581	7	10	371	261	7.7	85	22
El-Hendawy et al[27]	Retrospective multi- center	SR	NA	EL	105 (90-150)	7 (5-9)	5	2.5	NA	NA	NA	15 (9-20)	27.5	90	80
		LH	NA	EL	105 (100-150)	7 (5-9)	5	2.5	NA	NA	NA	20 (10-27)	40	90	80
		ERH	NA	EL	125 (100-150)1	7 (5-9)	5	2.5	NA	NA	NA	24 (10-28)1	35	87.5	80
Kohn et al[28]	Retrospective multi- center	SR	411	EM + EL	NA	5 (3-7)	3	NA	NA	NA	NA	16 (12-21)	37	76	NA
		EC	37	EM + EL	NA	5 (4-8)	3	NA	NA	NA	NA	18 (13-25)	37	75	NA
Degiuli et al[30]	Retrospective multi- center	SR	62.071	EM + EL	160 (120-210)	7 (6-10)	0.63	6.44	3.16	5.3	NA	16.85 ± 8.09	NA	84	85
		ERH + LH	50.68	EM + EL	189 (140-240)1	8 (6-10)	0.38	6.43	2.53	6.04	NA	20.08 ± 10.371	NA	83	84
Gravante et al[37]	Retrospective single center	LH	20.6	EM + EL	158 ± 411	NA	2.9	14.7	5.9	NA	0	13 (4-23)	NA	51.8	NA
		ERH	6.3	EM + EL	133 ± 50	NA	1.6	21.9	6.3	NA	4.7	16 (5-39)	NA	50.4	NA

¹Statistically significant.

SR: Segmental resection; LH: Left hemicolectomy; ERH: Extended right hemicolectomy; STC: Subtotal colectomy; ELH: Extended left hemicolectomy; EC: Extended colectomy; MIS: Minimally invasive surgery; EM: Emergency; EL: Elective; NA: Not available; LOS: Length of stay; LN: Lymph node; OS: Overall survival; DFS: Disease-free survival.