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High Tie or not in Resection for Cancer in the Sigmoid Colon?

Olofsson, F. LU ; Buchwald, P. LU ; Elmståhl, S. LU and Syk, I. LU (2018) In Scandinavian Journal of Surgery
Abstract

Background and Aims: The optimal extent of mesenteric resection in colon cancer surgery remains elusive. The aim was to assess the impact on perioperative morbidity and oncological outcome depending on the height of central vessel ligation in sigmoid resection for adenocarcinomas. Material and Methods: All cases of stage I–III sigmoid cancers, operated on with locally radical resections (2007–2009), were identified in the Swedish Colorectal Cancer Registry and categorized according to the position of the vascular ligature, that is, ligation of the inferior mesenteric artery, ligation of the superior rectal artery, or ligation of the sigmoid branches. Results: In total, 999 cases were identified and possible to categorize. Although... (More)

Background and Aims: The optimal extent of mesenteric resection in colon cancer surgery remains elusive. The aim was to assess the impact on perioperative morbidity and oncological outcome depending on the height of central vessel ligation in sigmoid resection for adenocarcinomas. Material and Methods: All cases of stage I–III sigmoid cancers, operated on with locally radical resections (2007–2009), were identified in the Swedish Colorectal Cancer Registry and categorized according to the position of the vascular ligature, that is, ligation of the inferior mesenteric artery, ligation of the superior rectal artery, or ligation of the sigmoid branches. Results: In total, 999 cases were identified and possible to categorize. Although higher ligation level yielded a higher number of lymph nodes, 3- or 5-year overall survival, 5-year disease-free survival, or recurrence rate did not differ between the groups (p = 0.79, p = 0.41, p = 0.67, p = 0.51). No differences in survival were detected after multivariate analysis adjusted for age, sex, T-stage, N-stage, American Society of Anesthesiologists classification, and adjuvant therapy. Conclusion: This large population-based study showed increased lymph node yield but no survival benefit or any decreased recurrence rate by high tie in resection of sigmoid cancer.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
cancer, Colon, high tie, lymph node, surgical technique
in
Scandinavian Journal of Surgery
publisher
Finnish Surgical Society
external identifiers
  • scopus:85058851102
ISSN
1457-4969
DOI
10.1177/1457496918812198
language
English
LU publication?
yes
id
e24cb8c5-84d1-4ec0-aab1-31f65fb7295d
date added to LUP
2019-01-07 14:37:58
date last changed
2019-02-20 11:41:54
@article{e24cb8c5-84d1-4ec0-aab1-31f65fb7295d,
  abstract     = {<p>Background and Aims: The optimal extent of mesenteric resection in colon cancer surgery remains elusive. The aim was to assess the impact on perioperative morbidity and oncological outcome depending on the height of central vessel ligation in sigmoid resection for adenocarcinomas. Material and Methods: All cases of stage I–III sigmoid cancers, operated on with locally radical resections (2007–2009), were identified in the Swedish Colorectal Cancer Registry and categorized according to the position of the vascular ligature, that is, ligation of the inferior mesenteric artery, ligation of the superior rectal artery, or ligation of the sigmoid branches. Results: In total, 999 cases were identified and possible to categorize. Although higher ligation level yielded a higher number of lymph nodes, 3- or 5-year overall survival, 5-year disease-free survival, or recurrence rate did not differ between the groups (p = 0.79, p = 0.41, p = 0.67, p = 0.51). No differences in survival were detected after multivariate analysis adjusted for age, sex, T-stage, N-stage, American Society of Anesthesiologists classification, and adjuvant therapy. Conclusion: This large population-based study showed increased lymph node yield but no survival benefit or any decreased recurrence rate by high tie in resection of sigmoid cancer.</p>},
  author       = {Olofsson, F. and Buchwald, P. and Elmståhl, S. and Syk, I.},
  issn         = {1457-4969},
  keyword      = {cancer,Colon,high tie,lymph node,surgical technique},
  language     = {eng},
  month        = {11},
  publisher    = {Finnish Surgical Society},
  series       = {Scandinavian Journal of Surgery},
  title        = {High Tie or not in Resection for Cancer in the Sigmoid Colon?},
  url          = {http://dx.doi.org/10.1177/1457496918812198},
  year         = {2018},
}