Extensive lymphadenectomy and high ligation of the inferior mesenteric artery for carcinoma of the left colon and rectum

High Tie of the Inferior Mesenteric Artery in Curative Surgery for Left Colonic and Rectal Cancers: A Systematic Review

“…In 8 patients (9%) a low IMA ligation would have left behind involved nodes, compromising the curative aspect of the operation. A larger study performed by Bacon et al [32] reported on 416 patients with cancer of the left colon, rectum, and anal canal, who underwent high IMA ligation with a peri-operative mortality rate of 3.1%. Lymph node metastases were present in 103 of 164 adenocarcinoma specimens available (62.8%), with 18 (17.3%) from patients having metastatic lymph node deposits at the IMA origin.…”

“…The incidence of lymph node metastases along the IMA varies widely, and although initial studies reported higher rates [14, 15, 32], the majority of recent studies agree that metastatic deposits at the root of the IMA occur in less than 5% of the patients [23, 24, 46, 54, 55]. Central lymph node metastases are generally associated with deposits in other regional lymph nodes, but in up to 6% of the cases these might be the only involved nodes [31, 54].…”

Selection of surgical approach and role of lymph node dissection at colorectal cancer

“…Bacon -17 % [5]. И чем больше инвазия опухоли в кишечную стенку, тем выше вероятность метастазиро-вания (0 % при pT1; 1,0-3,8 % при pT2; 2,6-11,5 % при pT3; 4,3-29,3 % при pT4) [11,12].…”

“…В своих работах в 1950-е годы он показал, что существует высокая частота пораже-ния апикальных ЛУ (до 17 %) при раке левой полови-ны ободочной кишки [3] и латеральных ЛУ при раке прямой кишки [4]. Выполнение расширенной лим-фодиссекции при раке левой половины ободочной кишки до внедрения химиотерапии позволяло увели-чивать общую выживаемость (ОВ) на 5 % (до 27,2 %) [5]. Во многом его идеологию перенял R. Turnbull.…”

Extended lymph node dissection in gastrointestinal cancer

“…In Duke's Stage C2, patients in the high ligation group fared significantly less well than similarly, staged patients in the low ligation group (Table VII). Bacon and Khubchandani [72] have compared a series of patients who had undergone extensive retroperitoneal dissection and radical hemicolectomy with patients who had undergone only segmental resection. They found a 6% increase in 5-year survival in the group that underwent radical resection, although the difference was not statistically significant (Table VII).…”