Selective approach to arterial ligation in radical sigmoid colon cancer surgery with D3 lymph node dissection: A multicenter comparative study

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dc.authoridEfetov, Sergey K./0000-0003-0283-2217
dc.authoridZubayraeva, Albina/0000-0001-8284-3922
dc.authoridKayaalp, Cuneyt/0000-0003-4657-2998
dc.authorwosidEfetov, Sergey K./AAJ-2728-2020
dc.authorwosidAlekberzade, Aftandil/P-8661-2015
dc.contributor.authorEfetov, Sergey
dc.contributor.authorZubayraeva, Albina
dc.contributor.authorKayaalp, Cuneyt
dc.contributor.authorMinenkova, Alisa
dc.contributor.authorBag, Yusuf
dc.contributor.authorAlekberzade, Aftandil
dc.contributor.authorTsarkov, Petr
dc.date.accessioned2024-08-04T20:10:17Z
dc.date.available2024-08-04T20:10:17Z
dc.date.issued2022
dc.departmentİnönü Üniversitesien_US
dc.description.abstractObjective: Radical surgery for sigmoid colon cancer is commonly performed with complete mesocolic excision (CME) and apical lymph node dissection, reached by central vascular ligation (CVL) of the inferior mesenteric artery (IMA) and associated extended left colon resection. However, IMA branches can be ligated selectively according to tumor location with D3 lymph node dissection (LND), economic segmental colon resection and tumorspecific mesocolon excision (TSME) if IMA is skeletonized. This study aimed to compare left hemicolectomy with CME and CVL and segmental colon resection with selective vascular ligation (SVL) and D3 LND. Material and Methods: Patients (n=217) treated with D3 LND for adenocarcinoma of the sigmoid colon between January 2013 and January 2020 were included in the study. The approach to vessel ligation, colon resection and mesocolon excision was based on tumor location in the study group, while in the comparison group, left hemicolectomy with routine CVL was performed. Survival rates were estimated as the primary endpoints of the study. Long- and short-term surgery-related outcomes were evaluated as the secondary endpoints of the study. Results: The studied approach to the IMA branch ligation was associated with a statistically significant decrease in intraoperative complication rates (2 vs 4, p=0.024), operative procedure length (225.56 +/- 80.356 vs 330.69 +/- 175.488, p<0.001), and severe postoperative morbidity (6.2% vs 19.1%, p=0.017). Meanwhile, the number of examined lymph nodes significantly increased (35.67 vs 26.69 per specimen, p<0.001). There were no statistically significant differences in survival rates. Conclusion: Selective IMA branch ligation and TSME resulted in better intraoperative and postoperative outcomes with no difference in survival rates.en_US
dc.identifier.doi10.47717/turkjsurg.2022.5867
dc.identifier.endpage390en_US
dc.identifier.issn2564-6850
dc.identifier.issn2564-7032
dc.identifier.issue4en_US
dc.identifier.pmid36875272en_US
dc.identifier.scopus2-s2.0-85146291739en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage382en_US
dc.identifier.trdizinid1169456en_US
dc.identifier.urihttps://doi.org/10.47717/turkjsurg.2022.5867
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/1169456
dc.identifier.urihttps://hdl.handle.net/11616/92694
dc.identifier.volume38en_US
dc.identifier.wosWOS:000946255400010en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakTR-Dizinen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherTurkish Surgical Assocen_US
dc.relation.ispartofTurkish Journal of Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectColon canceren_US
dc.subjectcomplete mesocolon excisionen_US
dc.subjectD3 lymph node dissectionen_US
dc.subjectcentral vascular ligationen_US
dc.subjectinferior mesenteric arteryen_US
dc.subjectsigmoid colonen_US
dc.titleSelective approach to arterial ligation in radical sigmoid colon cancer surgery with D3 lymph node dissection: A multicenter comparative studyen_US
dc.typeArticleen_US

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