Progress in sigmoidectomy for cancer during the last 24 years in our department.

BACKGROUND/AIMS: In the treatment for colon cancer, changes may have taken place in areas such as surgical devices, concepts for basic strategies, composition of the medical team, postoperative management and adjuvant chemotherapy. No one knows the net effect of these alterations in treatment on sigmoid colon cancer patients.

METHODOLOGY: A total of 147 patients were divided into 2 groups based upon the time of the surgery. Comparisons were made based upon the several parameters, including survival. In addition, to determine the effect of the degree of lymph node dissection on survival, patients were divided into 3 groups based upon the ligated portion of artery.

RESULTS

Blood loss significantly decreased. Other factors were almost the same except for survival. In Dukes' A and B, 5-year survival rates were the same (90%). But in Dukes' C, the 5-year survival rate was better in the later period (90%) than in the earlier period (70%). In Dukes' C, the extent of lymph node dissection significantly influenced the survival.

CONCLUSIONS

The parameters have not changed very much in these 24 years except for the 5-year survival rates in Dukes' C. The extent of lymph node dissection is probably sufficient just below the root of left colic artery.