Prospective comparison of laparoscopic left hemicolectomy for colon cancer with laparoscopic left hemicolectomy for benign colorectal disease.
BACKGROUND
Short-term outcome and anorectal function results after laparoscopic hemicolectomy for colon cancer were compared with results after laparoscopic hemicolectomy for benign diseases.


METHODS
A total of 108 patients who underwent laparoscopic left colectomy (60 for colon cancer, 48 for diverticulitis or polyposis) were enrolled in the study. Left hemicolectomy in patients affected by cancer was performed by high ligation of the inferior mesenteric artery. A questionnaire concerning anorectal function was mailed to patients 6 months after surgery.


RESULTS
Complications were more frequent in the cancer group than in the benign disease group: overall morbidity rate (29.6% versus 8.7%; P = 0.009), diarrhea during the first 6 postoperative months (58.7% versus 34.1%; P = 0.022), and anorectal function problems (fecal incontinence and/or the inability to discriminate between gas and stool, and/or urgency, and/or tenesmus) (65.2% versus 31.7%; P = 0.002).


CONCLUSIONS
The level of ligation of the lower mesenteric artery and damage at the lower mesenteric ganglion could explain the poorer anorectal function outcome in the colon cancer group.
Department of Surgical Sciences, Section of General Surgical Clinics and Surgical Therapy, Parma University Medical School, Via Gramsci 14, Parma, 43100, Italy. leosarli@unipr.it
Leopoldo
L
Sarli
Clara
C
Pavlidis
Francesco Giovanni
FG
Cinieri
Gabriele
G
Regina
Giuliano
G
Sansebastiano
Licia
L
Veronesi
Michelina
M
Ferro
Silvia
S
Morari
Vincenzo
V
Violi
Luigi
L
Roncoroni
D000368:Aged; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D004238:Diverticulitis / Q000601:surgery*; D005260:Female; D006801:Humans; D044483:Intestinal Polyposis / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome