Surgery for synchronous and metachronous colorectal cancer: segmental or extensive colectomy?
Surg Today
; 53(3): 338-346, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-36449083
ABSTRACT
PURPOSE:
To assess the impact of surgical approach on morbidity, mortality, and the oncological outcomes of synchronous (SC) and metachronous (MC) colorectal cancer (CRC).METHODS:
All patients undergoing resection for double location CRC (SC or MC) between 2006 and 2020 were included. The exclusion criteria were polyposis or SC located on the same side.RESULTS:
Sixty-seven patients (age, 64.8 years; male, 78%) with SC (n = 41; 61%) or MC (n = 26; 39%) were included. SC was treated with segmental colectomy (right and left colectomy/proctectomy; n = 19) or extensive colectomy (subtotal/total colectomy or restorative proctocolectomy with pouch; n = 22). Segmental colectomy was associated with a higher incidence of anastomotic leakage (47.4 vs. 13.6%; p = 0.04) and a higher rate of medical morbidity (47.4 vs. 16.6%; p = 0.04). The mean number of lymph nodes harvested was similar. For MC, the second cancer was treated by iterative colectomy (n = 12) or extensive colectomy (n = 14) and there was no significant difference in postoperative outcomes between the two surgical approaches. The median follow-up period was 42.4 ± 29.1 months. The 5-year overall and disease-free survival of the SC and MC groups did not differ to a statistically significant extent.CONCLUSIONS:
Extensive colectomy should be preferred for SC to reduce morbidity and improve the prognosis. In contrast, iterative colectomy can be performed safely for patients with MC.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Neoplasias Colorretais Hereditárias sem Polipose
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Proctocolectomia Restauradora
/
Segunda Neoplasia Primária
Tipo de estudo:
Prognostic_studies
Limite:
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Surg Today
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
França