title: Oncological impact of laparoscopic lymphadenectomy with preservation of the left colic artery for advanced sigmoid and rectosigmoid colon cancer.
abstract: BACKGROUND
  Laparoscopic lymphadenectomy around the inferior mesenteric artery (IMA) with preservation of the left colic artery (LCA) remains a controversial approach. The aim of the study was to investigate the clinical outcomes.
  
  
  METHODS
  This study analysed 211 patients who underwent laparoscopic resection of advanced (≥T3) sigmoid and rectosigmoid colon cancers with D3 lymphadenectomy including 91 high ligations of the IMA (HL) and 120 low ligations with preservation of the LCA (LL) from January 1998 to December 2009.
  
  
  RESULTS
  There were no significant differences in operative result between the groups. In stage II cancer, the overall survival rate (94.8% HL vs. 91.8% LL; 95% confidence interval (CI), -0.8 to 0.68, p = 0.920) and disease-free survival (93.0% HL vs. 87.6% LL; 95% CI, -0.8 to 0.40, p = 0.540) did not differ significantly between the two groups. A similar tendency in overall survival was observed in patients with stage III cancer (88.3% HL vs. 86.9% LL; 95% CI, -0.44 to 0.57, p = 0.989) and disease-free survival (71.4% HL vs. 69.8% LL; 95% CI, -0.38 to 0.40, p = 0.637).
  
  
  CONCLUSIONS
  Laparoscopic lymphadenectomy around the IMA with preservation of the LCA resulted in acceptable clinical outcomes in patients with advanced sigmoid and rectosigmoid colon cancer.
authors.affiliation: Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Junji
authors.initials: J
authors.lastname: Okuda
authors.forename: Keitaro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Ishii
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hamamoto
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012811:Sigmoid Neoplasms / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate