Narimantas Evaldas Samalavičius, Audrius Dulskas, Simonas Ūselis, Edgaras Smolskas
Background. The aim of the study was to evaluate thesafety and adequacy of high vascular ligation whileperforming surgery for left-sided colon cancer. Weperformed a retrospective analysis of prospectivelycollected data of patients operated laparoscopicallyfor sigmoid or descending colon cancer in a singletertiary care institution over a period of 10 years.Patients and methods. Between January 2007 andDecember 2016 hand-assisted laparoscopic surgery(HALS) was performed on 228 patients due to invasiveand histologically verified descending or sigmoidcolon cancer with high ligation of inferior mesentericartery and vein. Patients who had carcinoma in situwere excluded. The following variables were collectedand prospectively studied: age, sex, cancer localization,cancer stage, type of surgery, operative time,lymph node harvest, intraoperative complications,conversions, duration of hospital and postoperativestay, postoperative complications occurring within30 days. Complications were assessed by Clavien-Dindo classification.Results. Patient mean age was 64±10 years (range,40 – 86). There were 112 females (49.1 %) and 116males (50.9 %). A total of 149 (65.5 %) sigmoid colectomiesand 79 (34.5 %) left hemicolectomies havebeen performed. There were total of 71 (31 %) patientswith stage I disease, 67 (29.7 %) – stage II, 65(28.4 %) stage III and 25 (10.9 %) stage IV. Aerageoperative time was 105±39 minutes (range, 45-270).Average harvested lymph node count was 16.5±10(range, 10 – 90). Length of postoperative stay was6.3±3.2 days (range, 1-30). Eleven (4.82 %) patientshad complications, three of them (1,3%) were reoperated.There was no anastomotic leakage detectedin this group of patients.Conclusions. Our data support the opinion, that highvascular ligation while performing surgery for leftsided colon cancer is safe. Recorded lymphnodeharvest confirms oncological adequacy of such anapproach.
Keyword(s): laparoscopic surgery, left sided colon cancer, high ligation, lymphnode harvest.
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