| Title |
Strategy of laparoscopic surgery for colon cancer of the splenic flexure: a novel approach
|
|---|---|
| Published in |
Surgical Endoscopy, October 2017
|
| DOI | 10.1007/s00464-017-5870-9 |
| Pubmed ID | |
| Authors |
Naoki Matsumura, Hiromi Tokumura, Fumito Saijo, Yu Katayose |
| Abstract |
The splenic flexure (SF) anatomy is complex due to multiple vessels, surrounding organs, layers, and irregular adhesions [1-3]. Our laparoscopic approach involves a lateral-to-medial approach to the left-sided transverse mesocolon (TM), a medial-to-lateral approach to the left mesocolon (LM), and take-down of the remnant SF. First, the omental bursa is opened and its posterior wall and the anterior layer of the TM are dissected along the pancreas, where a gauze is placed. The TM is spread cephalad. A window in the TM is opened in the gauze seen through the TM. If necessary, the middle colic vessels are divided with lymph node (LN) dissection. Then the left colic artery is divided with LN dissection using a medial approach. The LM is widely dissected from the retroperitoneum to reach the TM window. While observing the pancreas through the window, the LM and TM are divided from the pancreas close to the SF. The descending colon is mobilized from its lateral attachment. Finally, the SF is taken down from the spleen by separating remnant structures, including adhesions. Subsequently, functional end-to-end anastomosis was performed extracorporeally. During March 2012-December 2016, 39 patients with left-sided transverse or descending colon cancer underwent this treatment. The mean operative time, blood loss, number of harvested LNs, and hospital stay duration were 283 min, 45 ml, 15, and 9 days, respectively. No patient needed conversion to open surgery or had organ injury, anastomotic leakage, or Clavien-Dindo III-V complications. There were 7/13/18/1 patients with Stage I/II/III/IV colon cancer, respectively. Nineteen cases had positive LNs. All patients were alive with one local and two distant recurrences at a mean 24-month follow-up. This is a safe and effective surgical strategy for treating colon cancer of the SF, strategically designed to resect the SF after dissecting the surrounding structures. |
X Demographics
The data shown below were collected from the profiles of 17 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 24% |
| Spain | 3 | 18% |
| United Kingdom | 2 | 12% |
| Egypt | 1 | 6% |
| Mexico | 1 | 6% |
| Portugal | 1 | 6% |
| Unknown | 5 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 47% |
| Scientists | 4 | 24% |
| Practitioners (doctors, other healthcare professionals) | 3 | 18% |
| Science communicators (journalists, bloggers, editors) | 2 | 12% |
Mendeley readers
The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 16 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 31% |
| Lecturer | 2 | 13% |
| Student > Master | 2 | 13% |
| Student > Ph. D. Student | 2 | 13% |
| Student > Postgraduate | 2 | 13% |
| Other | 2 | 13% |
| Unknown | 1 | 6% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 63% |
| Nursing and Health Professions | 1 | 6% |
| Engineering | 1 | 6% |
| Design | 1 | 6% |
| Unknown | 3 | 19% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 November 2017.
All research outputs
#3,862,506
of 23,577,761 outputs
Outputs from Surgical Endoscopy
#528
of 6,259 outputs
Outputs of similar age
#69,648
of 329,158 outputs
Outputs of similar age from Surgical Endoscopy
#18
of 136 outputs
Altmetric has tracked 23,577,761 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,259 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done particularly well, scoring higher than 91% of its peers.
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We're also able to compare this research output to 136 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.