Para-aortic Lymphadenectomy for Advanced Left Colon Cancer

Jiro Nagao, Yoshinobu Sumiyama

The Third Department of Surgery, Toho University School of Medicine

The use of systematic lymphadenectomy with clearance of the para-aortic lymphnodes for curable advanced left colon cancer was studied. This article outlines the procedure and states the performance in comparison with conventional radical approaches. In addition to the existing methods, this procedure clears the para-aortic lymphnodes up to the level of the renal vein and ligates the inferior mesenteric vein at the level of the inferior border of the pancreas. Twenty-nine patients have been treated by this procedure to date. Although the operating time was 36 minutes longer on average than that of the conventional approach, which clears up to the inferior mesenteric artery, the operations, due to their extended range have not been followed by posoperative dysfunction, which is frequently seen after lateral lymphnode dissection in low anterior resection for rectal cancer. Metastasis to the para-aortic lymphnodes was found in 2 of 29 patients (6.8%) and 4 of 348 recovered nodes (1.15%). We, therefore, conclude that extended lymphadenectomy is safe and efficacious procedure that maintains QOL.

Key words
left colon cancer, vertical lymphnode metastasis, para-aortic lymphadenectomy

Reprint requests
Jiro Nagao The Third Department of Surgery, Toho University School of Medicine
2-17-6 Oohashi, Meguro-ku, Tokyo, 153 JAPAN

Accepted
January 13, 1993

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