Surgical management of splenic flexure colonic malignancy

There is a lack of consensus on the optimal surgical approach for splenic flexure malignancies. Surgeons face the challenge of balancing successful oncological outcomes with the morbidity and functional effects of extended colonic resection, considering the variable 'watershed' vasculature and lymphatic anatomy of the splenic flexure. While there is an increasing body of evidence supporting the oncological safety of a more conservative segmental resection, most of the data stems from retrospective single center studies. This article reviews the management strategies and examines the evidence supporting various surgical approaches to splenic flexure malignancies.