Abstract
D3 lymph node dissection is necessary for T3/T4 colonic cancer; anomaly of the feeding artery is no exception. A 73-year-old man with sigmoid colon cancer was missing his inferior mesenteric artery. Instead, the marginal artery from the middle colonic artery was supplying blood to the cancer. On open laparotomy, the mesocolon was mobilized in the layer preserving the hypogastric nerve; sigmoidectomy with D3 dissection was performed as usual. pT3N0M0p Stage II was his diagnosis, and he has remained alive for 2 years without recurrence. A missing inferior mesenteric artery is a very rare anomaly, and the lymphatic flow in such a case is a matter of interest. If the paracolic lymph node is metastatic, whether to perform additional lymphadenectomy or not is controversial. The area of dissection of the lymph node must be decided individually in cases of feeding artery anomalies.
