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Impact of Left Colonic Artery Preservation on Anastomotic Leakage in Laparoscopic Sigmoid Resection and Anterior Resection for Sigmoid and Rectosigmoid Colon Cancer

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Abstract

Objectives

To investigate the effect of left colonic artery (LCA) preservation on laparoscopic sigmoidectomy outcomes

Methods

We identified 447 consecutive patients who underwent laparoscopic sigmoidectomy at our hospital group between January 2010 and December 2016. We divided the patients into groups with and without LCA preservation and with and without anastomotic leakage (AL). We compared the patient age and gender, tumor location, stage, D2/D3 lymph node dissection, comorbidities, operating time, and blood loss between these groups. Univariate and multivariate analyses were performed to determine the risk factors for AL.

Results

There were significant differences in age, sex, tumor location, D2/D3 lymph node dissection, hypertension, operating time, blood loss, and AL for groups with and without LCA preservation. There were significant differences in sex, tumor location, and LCA preservation for groups with and without AL. Multivariate analysis showed male sex (hazard ratio (HR) = 6.37, 95% confidence interval (CI) 2.39–20.6; p < 0.0001), non-LCA preservation (HR = 5.01, 95% CI 1.41–31.8.0; p = 0.01), and rectosigmoidal tumor location (HR = 2.51, 95% CI 1.15–5.61; p = 0.01) as significant independent risk factors for AL.

Conclusions

Based on the results obtained by performing laparoscopic operation for sigmoid colon cancer and rectosigmoid cancer, the LCA preservative procedure is warranted for prevention of AL.

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Abbreviations

LCA:

Left colonic artery

IMA:

Inferior mesenteric artery

AL:

Anastomotic leakage

HR:

Hazard ratio

CI:

Confidence interval

DM:

Diabetes mellitus

HT:

Hypertension

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Author information

Author notes

  1. Shinya Munakata: Senior authorship

Authors and Affiliations

  1. Department of Surgery, Juntendo Shizuoka Hospital, Juntendo University School of Medicine, 1129 Nagaoka, Izunokuni-shi, Shizuoka, 410-2295, Japan

    Hisaki Kato, Shinya Munakata, Riku Yamamoto, Shuhei Ueda, Satoshi Tokuda, Shunsuke Sakuraba, Tomoyuki Kushida, Hajime Orita, Mutsumi Sakurada, Hiroshi Maekawa & Koichi Sato

  2. Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan

    Shinya Munakata, Kazuhiro Sakamoto & Kiichi Sugimoto

Authors
  1. Hisaki Kato
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  2. Shinya Munakata
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  3. Kazuhiro Sakamoto
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  4. Kiichi Sugimoto
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  5. Riku Yamamoto
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  6. Shuhei Ueda
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  7. Satoshi Tokuda
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  8. Shunsuke Sakuraba
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  13. Koichi Sato
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Contributions

Study concept and design: SM; data acquisition: HK, SM, K. Sakamoto; analysis and interpretation of data: HK, SM, K. Sugimoto, YM, KS, RY, SU, ST, SS, TK, HO, MS, HM; drafting of the manuscript: SM; critical revision of the manuscript: K. Sato.

Corresponding author

Correspondence to Shinya Munakata.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was performed in accordance with the ethical standards of the Committee on Human Experimentation of our institution.

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Kato, H., Munakata, S., Sakamoto, K. et al. Impact of Left Colonic Artery Preservation on Anastomotic Leakage in Laparoscopic Sigmoid Resection and Anterior Resection for Sigmoid and Rectosigmoid Colon Cancer. J Gastrointest Canc 50, 723–727 (2019). https://doi.org/10.1007/s12029-018-0126-z

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  • DOI: https://doi.org/10.1007/s12029-018-0126-z

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