{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:46:36Z","timestamp":1791863196941,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Methods<\/jats:title>\n                    <jats:p>In sigmoid colon cancer surgery, the inferior mesenteric artery (IMA) can be ligated at its origin (high ligation, HLG) or distal to the left colic artery bifurcation (low ligation, LLG). While high ligation facilitates lymph node harvest and mobilization, it may compromise colonic perfusion and increase nerve injury risk. Low ligation preserves the LCA and may improve anastomotic blood supply. We conducted a retrospective multicenter study including patients who underwent sigmoidectomy for sigmoid colon cancer between January 2017 and December 2022. Short\u2010 and long\u2010term outcomes were compared between HLG and LLG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 185 patients were included (127 HLG, 58 LLG). Median postoperative length of stay was similar (6 vs. 5 days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.879). Anastomotic leak rates were 5.5% in HLG and 1.7% in LLG (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.438). Patients undergoing LLG had a higher comorbidity burden, and more than half of the cohort was aged\u2009\u2265\u200970 years. Lymph node yield was higher in HLG (20 vs. 15;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Three\u2010year disease\u2010free survival (85.5% vs. 87.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.751) and overall survival (89.7% vs. 80.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.098) were comparable, with no differences in recurrence patterns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IMA ligation level does not significantly influence outcomes. However, in elderly or fragile patients, low ligation achieves very low leak rates without compromising oncological safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70291","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:01:41Z","timestamp":1779778901000},"page":"263-271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Level of Vascular Ligation for Sigmoid Colon Cancer: Does It Matter? The Pina Low\u2010T Study"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5267-5331","authenticated-orcid":false,"given":"Silvia","family":"Picotto","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences University of Torino Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Seno","sequence":"additional","affiliation":[{"name":"Surgical Department \u201cE. Agnelli\u201d Pinerolo Hospital Pinerolo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3306-0360","authenticated-orcid":false,"given":"Marcello","family":"Calabr\u00f2","sequence":"additional","affiliation":[{"name":"Surgical Department \u201cE. Agnelli\u201d Pinerolo Hospital Pinerolo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Di Marzo","sequence":"additional","affiliation":[{"name":"Colorectal Surgical Oncology, IRCCS \u201cFondazione G. Pascale\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9472-3263","authenticated-orcid":false,"given":"Giuseppina","family":"Lo Moro","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences and Paediatrics University of Turin Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Santarelli","sequence":"additional","affiliation":[{"name":"Department of General and Emergency Surgery A.O.U. Citt\u00e0 della Salute e della Scienza di Torino Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Delrio","sequence":"additional","affiliation":[{"name":"Colorectal Surgical Oncology, IRCCS \u201cFondazione G. Pascale\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8049-6549","authenticated-orcid":false,"given":"Andrea","family":"Muratore","sequence":"additional","affiliation":[{"name":"Surgical Department \u201cE. Agnelli\u201d Pinerolo Hospital Pinerolo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.06.022"},{"key":"e_1_2_11_3_1","unstructured":"M.Adam G. J.Chang Y.\u2010J.Chen et al. \u201cNCCN Guidelines Version 2.2025 Colon Cancer Continue NCCN Guidelines Panel Disclosures \u201d 2025."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e318246f1a2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.774782"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-006-0221-7"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.4174\/astr.2018.94.4.209"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-022-02741-9"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-019-01942-2"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39406"},{"key":"e_1_2_11_11_1","unstructured":"A.Ssa R.Monzani andI. R.Bui. \u201cProtocollo Eras in Chirurgia Colorettale \u201d Italian Perioperative Program June2012."},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.JAA.0000531052.82007.42"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-018-3018-6"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-018-00612-1"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2022.100680"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001743"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005161"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70291","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jso.70291","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70291","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:05:57Z","timestamp":1791860757000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70291"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/jso.70291"],"URL":"https:\/\/doi.org\/10.1002\/jso.70291","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2026-02-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}