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Criteria for Satisfactory Colectomy for Carcinoma of the Left Colon: Description of Early High Ligation of the Inferior Mesenteric Vein

Criteria for Satisfactory Colectomy for Carcinoma of the Left Colon: Description of Early High... Abstract With the almost universal adoption of "left colectomy" rather than segmental resections of carcinomas of the sigmoid and left colon there is still some discrepancy in the type of operation advocated. Diversity of techniques of the component parts of a "left colectomy" results in disagreement as to what constitutes an adequate resection and leads to difficulties in the evaluation of the results of surgical treatment. As compared with resections of the right colon, there is no standardized left colectomy. An adequate and satisfactory resection for carcinoma of the colon should have for its purpose (1) the wide removal of the primary lesion in continuity with appropriate tissue pathways (venous and lymphatic) of potential secondary spread compatible with minimal morbidity and mortality; (2) the prevention of spread occurring as embolization or "seeding" during operation; (3) the recognition and removal of precursors of potential new growths, and (4) the salvage of as References 1. Halsted, W. S.: The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894 , Johns Hopkins Hosp. Rep. 4:1-54, 1894-1895 2. Ann. Surg. 20:497-555, 1894.Crossref 3. Fisher, D. R., and Turnbull, R. B., Jr.: The Cytologic Demonstration and Significance of Tumor Cells in the Mesenteric Venous Blood in Patients with Colorectal Carcinoma , Surg. Gynec. & Obst. 100:102-108, 1955. 4. Grinnell, R. S.: The Spread of Carcinoma of the Colon and Rectum , Cancer 3:641-652, 1950. 5. Barringer, P. L.; Dockerty, M. B.; Waugh, J. M., and Bargen, J. A.: Carcinoma of the Large Intestine: A New Approach to the Study of Venous Spread , Surg. Gynec. & Obst. 98:62-72, 1954. 6. Cole, W. H.; Packard, D., and Southwick, H. W.: Carcinoma of the Colon with Special Reference to Prevention of Recurrence , J. A. M. A. 155:1549-1553, 1954. 7. Cole, W. H.: Recurrence in Carcinoma of the Colon and Proximal Rectum Following Resection for Carcinoma , A. M. A. Arch. Surg. 65:264-270, 1954. 8. Gilchrist, R. K., and David, V. C.: A Consideration of Pathological Factors Influencing Five Year Survival in Radical Resection of the Large Bowel and Rectum for Carcinoma , Ann. Surg. 126:421-438, 1947. 9. Lillehei, R. C., and Wangensteen, O. H.: Bowel Function After Colectomy for Cancer, Polyps, and Diverticulitis , J. A. M. A. 159:163-179, 1955. 10. Wangensteen, O. H.; Lewis, F. J.; Arhelger, S. W.; Muller, J. J., and MacLean, L. D.: An Interim Report upon the "Second Look" Procedure for Cancer of the Stomach, Colon, and Rectum and for "Limited Intraperitoneal Carcinosis," Surg. Gynec. & Obst. 99:257-267, 1954. 11. Cruz, E. P.; McDonald, G. O., and Cole, W. H.: Prophylactic Treatment of Cancer: The Use of Chemotherapeutic Agents to Prevent Tumor Metastasis , Surgery 40:291-296, 1956. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Criteria for Satisfactory Colectomy for Carcinoma of the Left Colon: Description of Early High Ligation of the Inferior Mesenteric Vein

A.M.A. Archives Surgery , Volume 75 (3) – Sep 1, 1957

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280150032004
Publisher site
See Article on Publisher Site

Abstract

Abstract With the almost universal adoption of "left colectomy" rather than segmental resections of carcinomas of the sigmoid and left colon there is still some discrepancy in the type of operation advocated. Diversity of techniques of the component parts of a "left colectomy" results in disagreement as to what constitutes an adequate resection and leads to difficulties in the evaluation of the results of surgical treatment. As compared with resections of the right colon, there is no standardized left colectomy. An adequate and satisfactory resection for carcinoma of the colon should have for its purpose (1) the wide removal of the primary lesion in continuity with appropriate tissue pathways (venous and lymphatic) of potential secondary spread compatible with minimal morbidity and mortality; (2) the prevention of spread occurring as embolization or "seeding" during operation; (3) the recognition and removal of precursors of potential new growths, and (4) the salvage of as References 1. Halsted, W. S.: The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894 , Johns Hopkins Hosp. Rep. 4:1-54, 1894-1895 2. Ann. Surg. 20:497-555, 1894.Crossref 3. Fisher, D. R., and Turnbull, R. B., Jr.: The Cytologic Demonstration and Significance of Tumor Cells in the Mesenteric Venous Blood in Patients with Colorectal Carcinoma , Surg. Gynec. & Obst. 100:102-108, 1955. 4. Grinnell, R. S.: The Spread of Carcinoma of the Colon and Rectum , Cancer 3:641-652, 1950. 5. Barringer, P. L.; Dockerty, M. B.; Waugh, J. M., and Bargen, J. A.: Carcinoma of the Large Intestine: A New Approach to the Study of Venous Spread , Surg. Gynec. & Obst. 98:62-72, 1954. 6. Cole, W. H.; Packard, D., and Southwick, H. W.: Carcinoma of the Colon with Special Reference to Prevention of Recurrence , J. A. M. A. 155:1549-1553, 1954. 7. Cole, W. H.: Recurrence in Carcinoma of the Colon and Proximal Rectum Following Resection for Carcinoma , A. M. A. Arch. Surg. 65:264-270, 1954. 8. Gilchrist, R. K., and David, V. C.: A Consideration of Pathological Factors Influencing Five Year Survival in Radical Resection of the Large Bowel and Rectum for Carcinoma , Ann. Surg. 126:421-438, 1947. 9. Lillehei, R. C., and Wangensteen, O. H.: Bowel Function After Colectomy for Cancer, Polyps, and Diverticulitis , J. A. M. A. 159:163-179, 1955. 10. Wangensteen, O. H.; Lewis, F. J.; Arhelger, S. W.; Muller, J. J., and MacLean, L. D.: An Interim Report upon the "Second Look" Procedure for Cancer of the Stomach, Colon, and Rectum and for "Limited Intraperitoneal Carcinosis," Surg. Gynec. & Obst. 99:257-267, 1954. 11. Cruz, E. P.; McDonald, G. O., and Cole, W. H.: Prophylactic Treatment of Cancer: The Use of Chemotherapeutic Agents to Prevent Tumor Metastasis , Surgery 40:291-296, 1956.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Sep 1, 1957

References