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Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer

  • 0Department of Faculty Surgery No. 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. efetov@mail.ru.
Techniques in Coloproctology +

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December 31, 2024

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December 31, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Comparing surgical techniques for sigmoid cancer, D3 lymph node dissection with either high or low inferior mesenteric artery ligation offers a higher yield of lymph nodes and is safe. Low ligation with D2 lymphadenectomy was faster but yielded fewer lymph nodes.

Area Of Science

  • Colorectal Surgery
  • Surgical Oncology
  • Gastrointestinal Oncology

Background

  • The optimal extent of lymph node dissection (LND) and inferior mesenteric artery (IMA) ligation in sigmoid colon cancer surgery remains debated.
  • This study evaluates short-term outcomes of three distinct surgical techniques for sigmoid cancer resection.

Purpose Of The Study

  • To compare the short-term outcomes of three surgical techniques for sigmoid cancer.
  • To evaluate the impact of IMA ligation level and LND extent on operative parameters and complications.

Main Methods

  • A comparative study involving three groups of sigmoid colon cancer patients undergoing radical resection.
  • Group A: Low ligation (LL) IMA with D3-LND; Group B: High ligation (HL) IMA with D3-LND; Group C: LL IMA with D2-LND.
  • Key outcomes measured: operative time, blood loss, early postoperative complications, and harvested lymph node count.

Main Results

  • Group C (LL with D2-LND) had significantly shorter operative times (130 min) compared to Groups A and B (245 min and 257 min, respectively).
  • Group C experienced higher intraoperative blood loss (200 ml). Anastomotic leaks occurred in three patients in Group B.
  • Group C yielded fewer harvested lymph nodes (14) compared to Groups A and B.

Conclusions

  • Both high and low ligation of the IMA combined with D3-LND are safe and feasible for sigmoid cancer.
  • D3-LND techniques allow for a higher number of harvested lymph nodes compared to D2-LND.
  • LL with D2-LND is associated with reduced operative time but also a lower lymph node yield.

Keywords:

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