{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:41:16Z","timestamp":1784709676791,"version":"3.55.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Fewer than 10% of colon cancers are found at the splenic flexure. A standard surgical approach to these cancers has not been defined. The goal of this study was to compare lymph node harvest and post-operative morbidity between segmental resection and formal left hemicolectomy for splenic flexure colon cancers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Method<\/jats:title>\n                <jats:p>Patients diagnosed with a splenic flexure cancer were identified from the 2012\u20132018 ACS-NSQIP colectomy-targeted database. Patients were categorized based on type of surgical resection \u2013 left hemicolectomy with colorectal anastomosis or segmental colectomy with colocolonic anastomosis. Demographic, clinicopathologic, and post-operative outcomes were compared between groups. Factors independently associated with lymph node harvest, operative time, and post-operative morbidity were investigated by linear and binomial logistic regression models.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 3,049 patients underwent colectomy for a splenic flexure cancer. Of these, 83.6% had a segmental colectomy and 73% were performed by a minimally invasive approach. T- and N-stage did not differ between segmental and left hemicolectomy groups (<jats:italic>p<\/jats:italic>\u2009=\u20090.703 and <jats:italic>p<\/jats:italic>\u2009=\u20090.429, respectively). Inadequate nodal harvest (&lt;\u200912 nodes) was infrequent and similar between the two procedures (7.4% vs. 9.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.13). Operative time was significantly shorter for segmental colectomy (213\u2009\u00b1\u200983.5\u00a0min vs. 193\u2009\u00b1\u200984.1\u00a0min, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and major morbidity was similar between the two surgical techniques (8.4% vs. 8.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.75). After accounting for demographic, clinicopathologic, and operative factors, binomial logistic regression showed that type of procedure was not significantly associated with LN harvest (OR 0.80, 95%CI 0.54\u20131.17) or major morbidity (OR 1.17, 95%CI 0.36\u20133.81). However, on linear regression, segmental splenic flexure resection was associated with shorter operative time (estimate 20.29, 95%CI 12.61\u201327.97, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Splenic flexure resection for colon cancer is associated with an adequate lymph node harvest. Compared to a formal left hemicolectomy, a\u00a0segmental resection also has a shorter operative time with equivalent post-operative morbidity.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-021-08926-9","type":"journal-article","created":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T07:16:29Z","timestamp":1641021389000},"page":"5652-5659","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Segmental resection of splenic flexure colon cancers provides an adequate lymph node harvest and is a safe operative approach \u2013 an analysis of the ACS-NSQIP database"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8058-9051","authenticated-orcid":false,"given":"Allison J.","family":"Pang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Marinescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Morin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol-Ann","family":"Vasilevsky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marylise","family":"Boutros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,1]]},"reference":[{"key":"8926_CR1","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1007\/s005350070076","volume":"35","author":"T Nakagoe","year":"2000","unstructured":"Nakagoe T, Sawa T, Tsuji T, Jibiki M, Nanashima A, Yamaguchi H, Yasutake T, Ayabe H, Ishikawa H (2000) Carcinoma of the splenic flexure: multivariate analysis of predictive factors for clinicopathological characteristics and outcome after surgery. 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Allison Pang, Nancy Morin, and Carol-Ann Vasilevsky have no conflicts of interest or financial ties to disclose. Daniel Marinescu has no conflicts of interest or financial ties to disclose. Marylise Boutros has received speaking honoraria from Johnson & Johnson.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}