The techniques, short and long term outcomes of laparoscopic transverse colectomy comparing to laparoscopic hemicolectomy in mid-transverse colon cancer. 

Purpose: Our study was aimed to depict and summarize the technique, short and long term outcomes of laparoscopic transverse colectomy in one single clinical center and compare with laparoscopic hemicolectomy. Methods: This was a retrospective cohort study of patients with mid-transverse colon cancer in one single clinical center from February 2012 to October 2020. The enrolled patients were divided into two groups undergoing laparoscopic transverse colectomy and laparoscopic hemicolectomy, respectively. The intraoperative, postoperative complications, oncological outcomes and functional outcomes were compared between the two groups. The primary endpoint was disease free survival (DFS). Results: : The study enrolled 70 patients with 40 patients undergoing laparoscopic transverse colectomy and 30 patients undergoing hemicolectomy. The intraoperative accidental hemorrhage and multiple organ resection occurred similarly in the two groups. In transverse colectomy, caudal-to-cephalic approach was likely to harvest more lymph nodes although require more operation time than cephalic-to-caudal approach (23.1(14.3) versus 13.4(5.4) lymph nodes, P=0.004; 184.3(37.1)min versus 146.3(44.4)min, P=0.012). The laparoscopic transverse colectomy was marginally associated with lower incidence of overall postoperative complications and shorter postoperative hospital stay although without statistical significance (8(20.0%) versus 12(40.0%), P=0.067; 7(5-12) VS 7(5-18), P=0.060). The 3-year DFS showed no significant difference (3-year DFS 89.7% in transverse colectomy versus 89.9% in hemicolectomy, P=0.688) between the two groups. The alternating consistency of defecation occurred significantly less after transverse colectomy (15(51.7%) VS 20(80.0%), P=0.030). Conclusions: : The laparoscopic transverse colectomy is technically, oncologically and functionally feasible for mid-transverse colon cancer. Performing the caudal-to-cephalic approach might be more advantageous in lymphadenectomy.