Milone Marco, Manigrasso Michele, Elmore Ugo, Maione Francesco, Gennarelli Nicola, Rondelli Fabio, Velotti Nunzio, De Palma Giovanni Domenico
Department of Clinical Medicine and Surgery, Federico II University of Naples, Via Sergio Pansini, 5, 80131, Naples, Italy.
Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Vita Salute University, Via Olgettina Milano 58, 20132, Milan, Italy.
Int J Colorectal Dis. 2019 Feb;34(2):201-207. doi: 10.1007/s00384-018-3186-4. Epub 2018 Nov 6.
Provide the surgeon with a tool to decide the best surgical approach to transverse colon cancer.
To compare the surgical and oncological outcomes between transverse colectomy and extended hemicolectomy for patients with tumours of the transverse colon.
A systematic search was performed in the electronic databases (PubMed, Web of Science, Scopus, EMBASE), using the following search terms and/or MeSH terms in all possible combinations: transverse, transversus, colectomy, hemicolectomy, segmental resection, transverse colon cancer. The last search was performed on 10 May 2018.
Two independent authors (Mi.M. and N.V.) analysed each article and performed the data extraction independently. In case of disagreement, a third investigator was consulted (Ma.M.). Discrepancies were resolved by consensus.
Data regarding sample size, major clinical and demographic variables, oncologic outcomes and postoperative recovery and complications were extracted.
Main outcomes analysed were anastomotic leakage, early mortality, hospital stay, operative time, overall complications rate, wound infection, harvested nodes and disease-free survival.
No statistical differences were found between transverse colectomy and extended hemicolectomy in short- and long-term outcomes; our results revealed no differences in disease-free survival between the two surgical approaches. As expected, a statistically significant difference was found in favour of extended hemicolectomy in terms of number of harvested lymph nodes.
This systematic review with meta-analysis focus on the two major approaches to transverse colon cancer. The reviewed evidence suggests that a conservative approach to transverse colon cancer is feasible and safe and oncological outcomes are comparable between a conservative and an extended surgical procedure.
为外科医生提供一种工具，以决定横结肠癌的最佳手术方式。
比较横结肠癌患者行横结肠切除术与扩大半结肠切除术的手术及肿瘤学结局。
在电子数据库（PubMed、Web of Science、Scopus、EMBASE）中进行系统检索，使用以下检索词和/或医学主题词的所有可能组合：横、横向、结肠切除术、半结肠切除术、节段性切除术、横结肠癌。最后一次检索于2018年5月10日进行。
两位独立作者（米.M.和N.V.）分析每篇文章并独立进行数据提取。如有分歧，咨询第三位研究者（马.M.）。通过达成共识解决差异。
提取关于样本量、主要临床和人口统计学变量、肿瘤学结局、术后恢复及并发症的数据。
分析的主要结局为吻合口漏、早期死亡率、住院时间、手术时间、总体并发症发生率、伤口感染、获取的淋巴结数量及无病生存率。
横结肠切除术与扩大半结肠切除术在短期和长期结局方面未发现统计学差异；我们的结果显示两种手术方式在无病生存率方面无差异。正如预期的那样，在获取的淋巴结数量方面，扩大半结肠切除术具有统计学显著优势。
这项带有荟萃分析的系统评价聚焦于横结肠癌的两种主要手术方式。所审查的证据表明，对横结肠癌采取保守手术方式是可行且安全的，保守手术与扩大手术的肿瘤学结局相当。
