title: Laparoscopic Inferior Mesenteric Artery Peeling: An Alternative to High or Low Vascular Ligation for Sigmoid Colon Cancer Resection.
abstract: In sigmoid cancer, both inferior mesenteric artery high or low ligations are accepted for curative purposes. Since inferior mesenteric artery ligation could compromise blood flow to the anastomosis, potentially increasing anastomotic leakage onset, real oncological benefits and possible disadvantages related to vascular transection level are still on debate. We introduce totally laparoscopic inferior mesenteric artery peeling technique to release from the concept of lymph nodal harvesting linked to arterial transection level.
  
  
  
  Over a period of 24 months, 31 patients presenting with sigmoid cancer were submitted to laparoscopic sigmoidectomy associated with inferior mesenteric artery peeling. Data on intraoperative and postoperative outcomes have been prospectively collected.
  
  
  
  Mean operative time was 180 min (range 110-330 min); mean intraoperative blood loss was 60 ml (range 30-150 ml), and mean postoperative hospitalization was 6.2 days (range 4-11 days). Mean number of lymph node harvested was 16.7 (range 12-28).
  
  
  
  Given a proper selection of patients, laparoscopic sigmoidectomy comprehensive of sub-adventitial IMA skeletonization from its aortic origin could provide good oncological outcomes and recanalization rate. Further data are advocated to confirm these preliminary results.
authors.affiliation: Department of Surgery, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy. elisafrancone@gmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Francone
authors.affiliation: Department of Surgery, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy.
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Bonfante
authors.affiliation: Department of Surgery, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy.
authors.forename: Maria Santina
authors.initials: MS
authors.lastname: Bruno
authors.affiliation: Department of Pathological Anatomy, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Intersimone
authors.affiliation: Department of Surgery, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Falco
authors.affiliation: Department of Surgery, S. Andrea Hospital, POLL-ASL5, Via Vittorio Veneto 197, 19100, La Spezia, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Berti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010865:Pilot Projects; D011446:Prospective Studies; D012811:Sigmoid Neoplasms / Q000601:surgery*