Takuhisa Okada, MD, Shigeki Yamaguchi, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Hiroki Shimizu, Keniti Takemoto, Asami Suzuki, Shintaro Ishikawa. Saitama Medical University International Medical Center
Introduction: The splenic flexure colon cancer is relatively small number, the anatomical characteristics and the dominant artery are complicated. It is essential to accurately identify the lymph node dissection range. The distribution of lymph node metastasis was assessed from laparoscopic splenic flexure colon cancer resection at our hospital.
Materials: Harvested lymph nodes by laparoscopic splenic flexure colon cancer resection in which both the middle colonic artery (MCA) and left colic artery (LCA) were dissected, were examined in this study.
Results: There were 52 (29 males and 23 females) splenic flexure colon cancer resection from January 2012 to August 2017. The patients number of depth of invasion was; T1: 10, T2: 6, T3: 25, T4a: 10, T4b: 1, and those of pathological stage was; I: 14, IIA: 14, IIB: 2, IIC: 1, IIIA: 4, IIIB: 10, IIIC: 2, IV: 6. The lymph node metastasis was positive in 22 / 52 patients (42.3%), grades were; N1a: 10, N1b: 8, N2a: 3, N2b: 1. There were 14 patients of transverse colon cancer and 8 patients of descending colon cancer. The dominant vessels of transverse colon cancer were MCA: 8 patients, LCA: 3 patients, and accessory middle colon artery (acce.MCA): 3 patients. Despite transverse colon cancer, lymph node metastasis of the LCA region was observed in 4/14 patients (28.6%). The dominant vessels of descending colon cancer were LCA: 7 patients, acce.MCA: 1 patient. Despite descending colon cancer, lymph node metastasis of the MCA region was observed in 2/8 patients (25%).
Conclusion: It was suggested that lymph node dissection of both middle and left colic regions is necessary for splenic flexure colon cancer, because lymph node metastasis was recognized in both region.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86473
Program Number: P246
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster