ArticleSurgical endoscopy2018
Anatomical and embryological perspectives in laparoscopic complete mesocoloic excision of splenic flexure cancers.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- The emperor has no clothes-the need for standardized anatomical segment definitions in the management of colon cancer.International journal of colorectal disease · 2025Pooled it
- A standardized cranial-first robotic approach for splenic flexure-region colon cancer: technical description and feasibility in 23 cases.Updates in surgery · 2026Article
- Patterns of lymph node metastasis and long-term outcomes of splenic flexure colon cancer: a descriptive study from a Japanese high-volume center.Surgery today · 2025Article
- External validation of the Japanese difficulty score for laparoscopic hepatectomy in patients undergoing robotic-assisted hepatectomy.Surgical endoscopy · 2023Article
- Revisited Surgical Anatomy of the Left Colonic Angle for Tailored Carcinologic Colectomy: A Review.Journal of personalized medicine · 2023Review
- Gaining Mesenteric Length following Colorectal Resection: Essential Maneuvers to Avoid Anastomotic Tension.Clinics in colon and rectal surgery · 2023Review
- Comparison of clinical outcomes of single-incision versus multi-port laparoscopic surgery for descending colon cancer: a propensity score-matched analysis.BMC gastroenterology · 2022Article
- Re-interpreting mesenteric vascular anatomy on 3D virtual and/or physical models, part II: anatomy of relevance to surgeons operating splenic flexure cancer.Surgical endoscopy · 2022Article
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- Personalized surgery for the splenic flexure cancer: new frontiers.The British journal of surgery · 2022Article
- What is the best surgical procedure of transverse colon cancer? An evidence map and minireview.World journal of gastrointestinal oncology · 2021Review
- Extended right colectomy, left colectomy, or segmental left colectomy for splenic flexure carcinomas: a European multicenter propensity score matching analysis.Surgical endoscopy · 2021Article
- Robotic complete mesocolic excision for transverse colon cancer can be performed with a morbidity profile similar to that of conventional laparoscopic colectomy.Techniques in coloproctology · 2020Article
- Laparoscopic resection with complete mesocolic excision for splenic flexure cancer: long-term follow-up data from a multicenter retrospective study.Surgical endoscopy · 2020Article
- Arterial anatomy of the splenic flexure using preoperative three-dimensional computed tomography.International journal of colorectal disease · 2019Article
- Standardize the Surgical Technique and Clarify the Relevant Anatomic Concept for Complete Mobilization of Colonic Splenic Flexure Using da Vinci XiWorld journal of surgery · 2019Article
- Fully Robotic Resection of a Splenic Flexure Tumor with Intracorporeal Anastomosis.Diseases of the colon and rectum · 2019Article
- Modularized laparoscopic regional en bloc mesogastrium excision (rEME) based on membrane anatomy for distal gastric cancer.Surgical endoscopy · 2018Article
- How we do it: totally laparoscopic complete mesocolon excision for splenic flexure cancer.Langenbeck's archives of surgery · 2018Article
Corrections and comments
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic complete mesocoloic excision (CME) with central vascular ligation for splenic flexure cancer is technically challenging because of its anatomical complexity. Although embryological and anatomical consideration should be helpful to perform CME in colorectal cancer surgery, such studies on the splenic flexure are lacking.
methodsThe splenic flexure is located embryologically between the terminal portion of the midgut and the beginning of the hindgut, and is supplied by the superior mesenteric and inferior mesenteric arteries. The mesentery of the transverse and descending colon originally is a continuous sheet, although they rotate and partially fuse to each other during development. Our surgical strategy was excision of the transverse and descending mesocolon with ligation of the left colic artery and left branch of the middle colic artery, and extraction of the specimen in an intact package wrapped by the embryological planes.
resultsWe performed laparoscopic surgery according to our surgical strategy in 17 patients with splenic flexure colon cancer. There were no conversions to open surgery or serious intraoperative complications. Two patients had pathological stage (pStage) I, 5 pStage II, 9 pStage III, and 1 pStage IV disease. No patient had recurrence except for 1 with pStage IV cancer, with a median follow-up of 16 months.
conclusionsOur laparoscopic CME technique is feasible for treatment of splenic flexure cancer. Knowledge of anatomy based on embryology is essential to perform this surgery.
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