Hisaki Kato1, Shinya Munakata2,3, Kazuhiro Sakamoto4, Kiichi Sugimoto4, Riku Yamamoto1, Shuhei Ueda1, Satoshi Tokuda1, Shunsuke Sakuraba1, Tomoyuki Kushida1, Hajime Orita1, Mutsumi Sakurada1, Hiroshi Maekawa1, Koichi Sato1. 1. Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2295, Japan. 2. Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2295, Japan. smunaka@juntendo.ac.jp. 3. Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan. smunaka@juntendo.ac.jp. 4. Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Abstract
OBJECTIVES: To investigate the effect of left colonic artery (LCA) preservation on laparoscopic sigmoidectomy outcomes METHODS: We identified 447 consecutive patients who underwent laparoscopic sigmoidectomy at our hospital group between January 2010 and December 2016. We divided the patients into groups with and without LCA preservation and with and without anastomotic leakage (AL). We compared the patient age and gender, tumor location, stage, D2/D3 lymph node dissection, comorbidities, operating time, and blood loss between these groups. Univariate and multivariate analyses were performed to determine the risk factors for AL. RESULTS: There were significant differences in age, sex, tumor location, D2/D3 lymph node dissection, hypertension, operating time, blood loss, and AL for groups with and without LCA preservation. There were significant differences in sex, tumor location, and LCA preservation for groups with and without AL. Multivariate analysis showed male sex (hazard ratio (HR) = 6.37, 95% confidence interval (CI) 2.39-20.6; p < 0.0001), non-LCA preservation (HR = 5.01, 95% CI 1.41-31.8.0; p = 0.01), and rectosigmoidal tumor location (HR = 2.51, 95% CI 1.15-5.61; p = 0.01) as significant independent risk factors for AL. CONCLUSIONS: Based on the results obtained by performing laparoscopic operation for sigmoid colon cancer and rectosigmoid cancer, the LCA preservative procedure is warranted for prevention of AL.
OBJECTIVES: To investigate the effect of left colonic artery (LCA) preservation on laparoscopic sigmoidectomy outcomes METHODS: We identified 447 consecutive patients who underwent laparoscopic sigmoidectomy at our hospital group between January 2010 and December 2016. We divided the patients into groups with and without LCA preservation and with and without anastomotic leakage (AL). We compared the patient age and gender, tumor location, stage, D2/D3 lymph node dissection, comorbidities, operating time, and blood loss between these groups. Univariate and multivariate analyses were performed to determine the risk factors for AL. RESULTS: There were significant differences in age, sex, tumor location, D2/D3 lymph node dissection, hypertension, operating time, blood loss, and AL for groups with and without LCA preservation. There were significant differences in sex, tumor location, and LCA preservation for groups with and without AL. Multivariate analysis showed male sex (hazard ratio (HR) = 6.37, 95% confidence interval (CI) 2.39-20.6; p < 0.0001), non-LCA preservation (HR = 5.01, 95% CI 1.41-31.8.0; p = 0.01), and rectosigmoidal tumor location (HR = 2.51, 95% CI 1.15-5.61; p = 0.01) as significant independent risk factors for AL. CONCLUSIONS: Based on the results obtained by performing laparoscopic operation for sigmoid colon cancer and rectosigmoid cancer, the LCA preservative procedure is warranted for prevention of AL.
Entities:
Keywords:
Anastomotic leakage; Left colonic artery preservation; Sigmoid colon cancer
Authors: S Bonnet; A Berger; N Hentati; B Abid; J-M Chevallier; P Wind; V Delmas; R Douard Journal: Dis Colon Rectum Date: 2012-05 Impact factor: 4.585