Short- and long-term outcomes of preservation versus ligation of the inferior mesenteric artery in laparoscopic D3 lymph node dissection for descending colon cancer: a propensity score-matched analysis

Purpose This study aimed to compare the short- and long-term outcomes of laparoscopic D3 lymph node (LN) dissection between ligation of the inferior mesenteric artery (IMA) (LIMA) and preservation of the IMA (PIMA) for descending colon cancer using propensity score-matched analysis. Methods This ret...

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Published in:Langenbeck's archives of surgery 2023-01, Vol.408 (1), p.23-23, Article 23
Main Authors: Sato, Aya, Imaizumi, Ken, Kasajima, Hiroyuki, Ichimura, Kentaro, Sato, Kentaro, Yamana, Daisuke, Tsuruga, Yosuke, Umehara, Minoru, Kurushima, Michihiro, Nakanishi, Kazuaki
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cardiac Surgery
Colon, Descending - pathology
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
General Surgery
Humans
Laparoscopy
Ligation
Lymph Node Excision
Medicine
Medicine & Public Health
Mesenteric Artery, Inferior - surgery
Potassium Iodide
Propensity Score
Retrospective Studies
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
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Summary:Purpose This study aimed to compare the short- and long-term outcomes of laparoscopic D3 lymph node (LN) dissection between ligation of the inferior mesenteric artery (IMA) (LIMA) and preservation of the IMA (PIMA) for descending colon cancer using propensity score-matched analysis. Methods This retrospective study included 101 patients with stage I–III descending colon cancer who underwent laparoscopic D3 LN dissection with LIMA ( n  = 60) or PIMA ( n  = 41) at a single center between January 2005 and March 2022. After propensity score matching, 64 patients (LIMA, n  = 32; PIMA, n  = 32) were included in the analysis. The primary endpoint was the long-term outcomes, and the secondary endpoint was the surgical outcomes. Results In the matched cohort, no significant difference was noted in the surgical outcomes, including the operative time, estimated blood loss, number of harvested LNs, number of harvested LN 253, and complication rate. The long-term outcomes were also not significantly different between the LIMA and PIMA groups (3-year recurrence-free survival, 72.2% vs. 75.6%, P  = 0.862; 5-year overall survival, 69.8% vs. 63.4%, P  = 0.888; 5-year cancer-specific survival, 84.2% vs. 82.8%, P  = 0.607). No recurrence of LN metastasis was observed around the IMA root. Conclusion Laparoscopic D3 dissection in PIMA was comparable to that in LIMA regarding both short- and long-term outcomes. The optimal LN dissection for descending colon cancer should be investigated in future large-scale studies.
ISSN:1435-2451
1435-2451
DOI:10.1007/s00423-023-02771-1