Jeff Conner, MD, Andrew Schlussel, MD. Madigan Army Medical Center
Introduction: Oncologic resections for transverse colon cancer have traditionally been approached via extended right and left colectomy. While laparoscopic techniques have been validated to be an acceptable approach for colon cancer, segmental transverse colectomy is not the traditional described technique for treating transverse colon cancer. If an adequate oncologic resection can be attained with similar outcomes compared to traditional techniques, utilizing a laparoscopic transverse colectomy has potential for sparing patients unnecessary resection of otherwise normal colon.
Video Content: We present a 45-year-old male with a mid transverse colon cancer diagnosed on colonoscopy after workup for symptomatic anemia. Due to the location of the mass, we proceeded with a laparoscopic transverse colectomy, instead of the traditionally described extended left or right colectomy. Key steps in order to facilitate an oncologic resection of a transverse colon cancer via a transverse colectomy are demonstrated. A medial to lateral approach for mobilizing the splenic and hepatic flexures is seen, as well as high ligation of the middle colic artery to ensure adequate lymph node excision. We demonstrate sufficient mobilization of the hepatic and splenic flexures in order to provide a tension free anastomosis and still produce an acceptable oncologic resection.
Conclusions: Oncologic resection for transverse colon cancer may be approached via a transverse colectomy on a case by case basis. Utilizing a laparoscopic transverse colectomy for transverse colon cancer may be an acceptable technique adopted by colorectal surgeons. Using simple laparoscopic technique this dissection and oncologic resection may be an alternative to the traditional extended left and right colectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95859
Program Number: V050
Presentation Session: Colorectal II – Neoplasia
Presentation Type: Video