Outcomes of segmental and extended colectomy for mid-transverse colon cancer. A retrospective study

AIM: to compare early and late results after segmental and extended resections in middle third transverse colon cancer.

PATIENTS AND METHODS: a retrospective study included 86 patients with middle third transverse colon cancer who underwent resection between 2017–2023. Patients were divided into segmental resection (SR) (n = 55) and extended colectomy (EC) (n = 31) groups. Intraoperative parameters, incidence, nature of postoperative morbidity and histopathological findings were evaluated. Late outcomes and functional results were analysed. Statistical analysis included regression models to identify complication predictors.

RESULTS: postoperative complications in the CP group were lower than after extended surgery — 11/55 (20%) versus 13/31 (41.9%) cases (p = 0.04). In multivariate analysis, independent predictors of an increase in the likelihood of complications were stapler anastomosis (OR = 9.48; 95% CI: 1.88–57.66; p = 0.008) and the pN2 (odd ratio (OR) = 3.63; 95% confidence interval (CI): 1.11–12.34; p = 0.03). The volume of resection had no significant effect on the risk of complications (OR = 2.8; 95% CI: 0.97–8.33; p = 0.11). With EC, more lymph nodes were removed than with SR — 20 (15.7; 32.2) versus 29 (21; 48) (p = 0.005), while the rate of their metastatic lesion was 0 (0; 4) for both groups (p = 0.44), and the 5–year overall survival with a median follow-up of 52 (34.7; 68.5) months was 86% for SR versus 78.3% for EC (p = 1.0) did not differ significantly between the groups. The study of the frequency of bowel movements in the late period was 2 (1;2) times/day in both groups (p = 0.97), as well as the shape and consistency of faeces (type 3 prevailed according to the Bristol scale — 31/46 (67.4%) for SR and 20/28 (71.4%) for EC (p = 0.8)) revealed no significant differences between the groups.

CONCLUSION: postoperative complications in the segmental colon resection group is lower than in the dilated colon group. The volume of surgery was not an independent predictor of complications. The likelihood of their development was increased by the use of stapler for anastomosis and the pN2 criterion. The late results in the groups did not differ.

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