Published online May 15, 2021. doi: 10.4251/wjgo.v13.i5.391
Peer-review started: January 15, 2021
First decision: February 14, 2021
Revised: February 25, 2021
Accepted: March 31, 2021
Article in press: March 31, 2021
Published online: May 15, 2021
Processing time: 112 Days and 0.4 Hours
Colorectal cancers comprise a large percentage of tumors worldwide, and transverse colon cancer (TCC) is defined as tumors located between hepatic and splenic flexures. Due to the anatomy and embryology complexity, and lack of large randomized controlled trials, it is a challenge to standardize TCC surgery. In this study, the current situation of transverse/extended colectomy, robotic/ laparoscopic/open surgery and complete mesocolic excision (CME) concept in TCC operations is discussed and a heatmap is conducted to show the evidence level and gap. In summary, transverse colectomy challenges the dogma of traditional extended colectomy, with similar oncological and prognostic outcomes. Compared with conventional open resection, laparoscopic and robotic surgery plays a more important role in both transverse colectomy and extended colectomy. The CME concept may contribute to the radical resection of TCC and adequate harvested lymph nodes. According to published studies, laparoscopic or robotic transverse colectomy based on the CME concept was the appropriate surgical procedure for TCC patients.
Core Tip: Due to the anatomy and embryology complexity, and the lack of large randomized controlled trials, it is difficult to standardize surgery of transverse colon cancer (TCC). This study discusses the possible appropriate surgical procedures of TCC patients and a heatmap was conducted to show the evidence level and gap. In summary, transverse colectomy challenges the dogma of traditional extended colectomy, with similar oncological and prognostic outcomes.