High vascular ligation in left-sided colon cancer surgery is safe and adequate

We aimed to evaluate the safety and adequacy of high vascular ligation in surgery for left-sided colon cancer.

Between 2007 and 2016, hand-assisted laparoscopic surgery was performed on 228 patients for descending or sigmoid colon cancer with high ligation of the inferior mesenteric artery and vein. We collected and prospectively studied demographic, clinical, and long-term outcome results. Complications were assessed with the Clavien–Dindo classification. The 5‑year survival (OS) and 5‑year disease-free survival (DFS) probability rates were calculated using Kaplan–Meier curves.

There were 71 (31%) patients with stage I disease, 67 (29.7%) with stage II, 65 (28.4%) with stage III, and 25 (10.9%) with stage IV. The average harvested lymph node count was 16.5 ± 10 (range, 10–90). Length of postoperative hospital stay was 6.3 ± 3.2 days (range, 1–30). Eleven (4.82%) patients had complications, and three of them (1.3%) were re-operated. There was no anastomotic leakage detected in our group of patients. The five-year OS of all stages using Kaplan–Meier curves was 0.75 and the DFS was 0.8.

Our data support the opinion that high vascular ligation while performing surgery for left-sided colon cancer is safe. Long-term oncological outcomes were similar to those presented in other studies.