Short- and long-term outcomes after transverse versus extended colectomy for transverse colon cancer. A systematic review and meta-analysis.

Abstract

Provide the surgeon with a tool to decide the best surgical approach to transverse colon cancer. To compare the surgical and oncological outcomes between transverse colectomy and extended hemicolectomy for patients with tumours of the transverse colon. A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search terms and/or MeSH terms in all possible combinations: transverse, transversus, colectomy, hemicolectomy, segmental resection, transverse colon cancer. The last search was performed on 10 May 2018. Two independent authors (Mi.M. and N.V.) analysed each article and performed the data extraction independently. In case of disagreement, a third investigator was consulted (Ma.M.). Discrepancies were resolved by consensus. Data regarding sample size, major clinical and demographic variables, oncologic outcomes and postoperative recovery and complications were extracted. Main outcomes analysed were anastomotic leakage, early mortality, hospital stay, operative time, overall complications rate, wound infection, harvested nodes and disease-free survival. No statistical differences were found between transverse colectomy and extended hemicolectomy in short- and long-term outcomes; our results revealed no differences in disease-free survival between the two surgical approaches. As expected, a statistically significant difference was found in favour of extended hemicolectomy in terms of number of harvested lymph nodes. This systematic review with meta-analysis focus on the two major approaches to transverse colon cancer. The reviewed evidence suggests that a conservative approach to transverse colon cancer is feasible and safe and oncological outcomes are comparable between a conservative and an extended surgical procedure.