Long-term Oncological Results After Laparoscopic Sigmoidectomy for Adenocarcinoma

Purpose: Sigmoidectomy is performed in most cases for benign pathologies and mainly in cases of diverticulitis. Few studies in the literature report oncological results after sigmoidectomy for adenocarcinoma. The aim of this study was to report the long-term oncological outcomes after elective laparoscopic sigmoidectomy (LS) for adenocarcinoma.Methods: This study is a retrospective analysis of prospectively collected data. From January 2003 to February 2021, 173 patients underwent elective LS for adenocarcinoma. Twenty-four patients with a diagnosis of preoperative distant metastases were excluded (13.9%).Results: Seven postoperative complications were observed (7.1%). Of these, 2 (2%) anastomotic leakages were treated surgically by the Hartmann procedure (Clavien-Dindo grade III-b). The mean number of harvested lymph nodes with the specimen was 14.2 +/- 7.1. At a median follow-up of 115 months (interquartile range 133.8), 2 (2%) and 9 patients (9.2%) had developed recurrence and metastases, respectively. During follow-up, 6 patients (6.1%) with metastases died due to disease progression and 6 other patients (6.1%) died due to causes other than cancer related. At the 5- and 10-year follow-ups, the overall survival rates were 90.5% +/- 3.4% and 83.8% +/- 4.5%, respectively, while the disease-free survival rates were 87.1% +/- 4.1% and 83.5% +/- 4.7%, respectively.Conclusion: LS is a safe and feasible technique both in terms of the number of harvested lymph nodes and oncological results. The possibility of sparing the colon without mobilizing the splenic flexure and dividing the left colic artery could reduce intra- and postoperative complications. Further studies with larger samples of patients are required to confirm these data.