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World J Gastrointest Oncol. May 15, 2021; 13(5): 391-399
Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.391
What is the best surgical procedure of transverse colon cancer? An evidence map and minireview
Chen Li, Quan Wang, Ke-Wei Jiang
Chen Li, Quan Wang, Ke-Wei Jiang, Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing 100044, China
Author contributions: Li C contributed to the research design and wrote the paper; Wang Q contributed to the supervised the manuscript and design the evidence and gap map; Jiang KW contributed to the research design and supervised the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke-Wei Jiang, MD, PhD, Adjunct Professor, Chairman, Chief Doctor, Director, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. jiangkewei@pkuph.edu.cn
Received: January 15, 2021
Peer-review started: January 15, 2021
First decision: February 14, 2021
Revised: February 25, 2021
Accepted: March 31, 2021
Article in press: March 31, 2021
Published online: May 15, 2021
Abstract

Colorectal cancers comprise a large percentage of tumors worldwide, and transverse colon cancer (TCC) is defined as tumors located between hepatic and splenic flexures. Due to the anatomy and embryology complexity, and lack of large randomized controlled trials, it is a challenge to standardize TCC surgery. In this study, the current situation of transverse/extended colectomy, robotic/ laparoscopic/open surgery and complete mesocolic excision (CME) concept in TCC operations is discussed and a heatmap is conducted to show the evidence level and gap. In summary, transverse colectomy challenges the dogma of traditional extended colectomy, with similar oncological and prognostic outcomes. Compared with conventional open resection, laparoscopic and robotic surgery plays a more important role in both transverse colectomy and extended colectomy. The CME concept may contribute to the radical resection of TCC and adequate harvested lymph nodes. According to published studies, laparoscopic or robotic transverse colectomy based on the CME concept was the appropriate surgical procedure for TCC patients.

Keywords: Evidence map, Extended colectomy, Review, Surgical procedures, Transverse colectomy, Transverse colon cancer

Core Tip: Due to the anatomy and embryology complexity, and the lack of large randomized controlled trials, it is difficult to standardize surgery of transverse colon cancer (TCC). This study discusses the possible appropriate surgical procedures of TCC patients and a heatmap was conducted to show the evidence level and gap. In summary, transverse colectomy challenges the dogma of traditional extended colectomy, with similar oncological and prognostic outcomes.