Cancer of the sigmoid colon: left hemicolectomy or sigmoidectomy?

Left hemicolectomy is the ideal treatment of sigmoid cancer, but sometimes sigmoidectomy is a safe treatment. We radically treated 102 patients affected by sigmoid cancer: 83 were gross sigmoid cancer treated by left hemicolectomy, 19 were residual cancer after endoscopic polypectomy; of these, 4 underwent left hemicolectomy and 15 underwent sigmoidectomy. No recurrence was observed in the 15 patients treated by sigmoidectomy. In patients with sigmoid cancer accidentally associated with sigmoid diverticulitis, the surgeon should extend the resection up to a left hemicolectomy or follow-up with the patient, but sometimes sigmoidectomy could be safe. The sentinel lymph node technique in colorectal cancer could suggest indications to complementary treatments. However, in the presence of a negative node, sigmoidectomy could probably be planned as a rational treatment. In conclusion, even if more data are required, in some selected cases of sigmoid cancer, sigmoidectomy could be a safe treatment.