Inferior mesenteric artery skeletization with para-aortic lymphadenectomy in the treatment of left-sided colon cancer
Abstract
Aim of investigation. Development and efficacy evaluation of oncologically proved and safe surgical methods for various locations and stages of left-sided colon cancer.
Material and methods. Overall 59 patients with left-sided colon cancer were selected from February, 2008 to May, 2011. All patients underwent bowel resection in different volume with para-aortic lymph node dissection and skeletization of inferior mesenteric artery (detailed description of the procedure is presented): 11 left-side hemycolectomies, 14 partial resections of the left colon, 13 distal and 21 segmentary resection of sigmoid colon were executed.
Results. The highest duration of operation (250,9±71,5 min) and volume of intraoperative blood loss (745,4±737,0 ml) was observed at left-side hemicolectomy, duration of other interventions did not exceed 3 h, and the blood loss – was less than 250 ml. Postoperative complications developed in 9 patients. The mean number of investigated lymph nodes in resected speciemens was 26,4±18,2. Metastatic involvement was most frequent in paracolic lymph nodes, affected apical lymph nodes are revealed in 2 cases. Cumulative three-year survival rate was 93%.
Conclusion. Applied technique of inferior mesenteric artery skeletization allows to carry out extensive para-aortic lymph node dissection and to keep supplying vessels. This allows to decrease considerably the number of left-side hemicolectomies for segmentary resections. Presented interventions are safe from the point of postoperative morbidity and are characterized by good oncologic results.
About the Authors
P. V. Tsarkov
Российский научный центр хирургии им. Б.В. Петровского РАМН
Russian Federation
Russian Federation
A. Yu. Kravchenko
Российский научный центр хирургии им. Б.В. Петровского РАМН
Russian Federation
Russian Federation
I. A. Tulina
Российский научный центр хирургии им. Б.В. Петровского РАМН
Russian Federation
Russian Federation
B. N. Bashankayev
Российский научный центр хирургии им. Б.В. Петровского РАМН
Russian Federation
Russian Federation
O. Yu. Samofalova
Российский научный центр хирургии им. Б.В. Петровского РАМН
Russian Federation
Russian Federation
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For citations:
Tsarkov P.V., Kravchenko A.Yu., Tulina I.A., Bashankayev B.N., Samofalova O.Yu. Inferior mesenteric artery skeletization with para-aortic lymphadenectomy in the treatment of left-sided colon cancer. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(2):60-70. (In Russ.)
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