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RESEARCH ARTICLE
Laparoscopic Extended Hemicolectomy vs Laparoscopic

Transverse Colectomy for Management of Mid-transverse

Colon Cancer—Which is the Optimal Surgical Approach?

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Abdelwahab S Almoregy , Gamal Osman , Mahmoud Sharafedeen , Ahmed Z Alattar , Ola A Harb , Ehab M Oraby 6
AbstrAct
Background: Laparoscopic-assisted surgical approach performing either extended right or left hemicolectomy or performing only conservative
approach by transverse colectomy could be considered as various management approaches of cancer of the transverse colon but a consensus of
which technique is the best is still lacking. So the choice of surgical approach depends on the preference and experience of the operating surgeon.
Aim: The aim of this study was to compare performing laparoscopic extended right or left hemicolectomy and performing transverse colectomy
for management of transverse colon cancer located in the middle part of the transverse colon regarding surgical and oncological findings and
patients’ outcomes to prove which surgical approach is the best.
Patients and methods: We analyzed collected data of 120 patients with mid-transverse colon cancer. We divided them into two groups: the first
group included 80 patients who were managed by right or left hemicolectomy and the second group included 40 patients who were managed
by transverse colectomy. We evaluated operative, postoperative, and follow-up data of all included patients.
Results: The length of specimens was longer in the hemicolectomy group than that in the transverse colectomy group (p = 0.007). The numbers
of dissected lymph nodes were significantly higher in the hemicolectomy group than in the transverse colectomy group (p <0.001). The
duration of operative time was longer in the hemicolectomy group than in the transverse colectomy group (p = 0.014). The group of patients
in the hemicolectomy group experienced a higher rate of recovery findings than the transverse colectomy group. The group of patients in
the hemicolectomy group experienced lower rates of intraoperative and perioperative complications than the transverse colectomy group
(p = 0.002). Five years of overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) rates were slightly longer in the
hemicolectomy groups than those in the transverse colectomy group, but results were not statistically significant.
Conclusion: We concluded that hemicolectomy is a better surgical approach of management of cancer located in the mid-transverse colon
regarding operative and short-term outcomes than transverse colectomy, but regarding oncological outcomes, both techniques are considered
safe and feasible.
Keywords: Hemicolectomy, Laparoscopic, Mid-transverse colon cancer, Transverse colectomy.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1478

IntroductIon 1,2 Department of General Surgery, Zagazig University, Zagazig, Egypt
Carcinoma which is located in the transverse colon forms about 10% 3 Department of Internal Medicine, Zagazig University, Zagazig, Egypt
1
of all colorectal cancers. The survival rates and patients’ outcomes 4 Department of Clinical Oncology and Nuclear Medicine, Zagazig
were found to be worse than cancers located elsewhere in the colon University, Zagazig, Egypt
2
and rectum. This dismal outcome might be due to, late discovery 5 Department of Pathology, Zagazig University, Zagazig, Egypt
and diagnosis, dual lymphatic metastases along both branches 6
of mesenteric vessels, and proximity to vital abdominal organs. 3 Department of General Surgery, Benha University, Benha, Egypt
Laparoscopic-assisted surgical management of cancer of Corresponding Author: Ola A Harb, Department of Pathology, Zagazig
the transverse colon is recently gaining acceptance to be an optimal University, Zagazig, Egypt, e-mail: olaharb2015@gmail.com
management procedure. But the optimal approach for the manage- How to cite this article: Almoregy AS, Osman G, Sharafedeen M, et al.
ment of cancer located in the mid-transverse colon is still controversial. 4 Laparoscopic Extended Hemicolectomy vs Laparoscopic Transverse
Previous reports stated that performing either extended right Colectomy for Management of Mid-transverse Colon Cancer—Which is
or left hemicolectomy or only conservative approach by transverse the Optimal Surgical Approach? World J Lap Surg 2021;14(3):215–220.
colectomy could be considered various management approaches, Source of support: Nil
but a consensus of which technique is the best is still lacking. So Conflict of interest: None
the choice of surgical approach depends on the preference and
experience of the operating surgeon. 1 PAtIents And Methods
The aim of this study was to compare performing laparoscopic
extended right or hemicolectomy and performing transverse Patients
colectomy for the management of transverse colon cancer located This prospective study was approved by the local ethics committee
in the middle part of the transverse colon regarding surgical and of Faculty of Medicine, Zagazig University Institutional Review Board.
oncological findings and patients’ outcomes to prove which surgical We analyzed the collected data of mid-transverse colon cancer
approach is the best. patients who were surgically managed by either laparoscopic-

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