ABSTRACT
Left hemicolectomy traditionally refers to resection of the descending colon, usually including the splenic flexure, resulting in an anastomosis between the transverse colon and the sigmoid colon. Many Western colons have diverticular disease and the sigmoid colon may be unsuitable due to muscular thickening and the presence of diverticular for anastomosis, necessitating anastomosis with the rectum. This is covered in Chapter 5.5. The majority of pure left hemicolectomies, when suitable to be performed, are done for polyps or malignancy in the elderly. Otherwise, in fit patients higher ligation than the colic artery by including the inferior mesenteric artery (IMA) and removal of its lymph nodes necessitates an anterior resection, and is preferred by many Western surgeons.
