Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.825
Peer-review started: December 27, 2022
First decision: January 20, 2023
Revised: January 29, 2023
Accepted: March 15, 2023
Article in press: March 15, 2023
Published online: May 27, 2023
During laparoscopic resection for colorectal cancer, there is controversy regarding whether the left colic artery (LCA) should be preserved at its origin.
To investigate the prognostic significance of preservation of the LCA in colorectal cancer surgery.
Patients were divided into two groups. The high ligation (H-L) technique (refers to ligation performed 1 cm from the beginning of the inferior mesenteric artery) group consisted of 46 patients, and the low ligation (L-L) technique (refers to ligation performed below the initiation of the LCA) group consisted of 148 patients. Operative time, blood loss, lymph nodes with tumor invasion, post
The average number of lymph nodes detected in postoperative pathological specimens was 17.4/person in the H-L group and 15.9/person in the L-L group. There were 20 patients (43%) with positive lymph nodes (lymph node metastasis) in the H-L group and 60 patients (41%) in the L-L group. No statistical differences were found between the groups. Complications occurred in 12 cases (26%) in the H-L group and in 26 cases (18%) in the L-L group. The incidences of postoperative anastomotic complications and functional urinary complications were significantly lower in the L-L group. The 5-year survival rates in H-L and L-L groups were 81.7% and 81.6%, respectively, and relapse-free survival rates were 74.3% and 77.1%, respectively. The two groups were similar statistically.
Complete mesenteric resection combined with lymph node dissection around the inferior mesenteric artery root while preserving the LCA is a beneficial surgical approach during laparoscopic resection for colorectal cancer.
Core Tip: Colorectal cancer is a common disease. The operative method is related to the prognosis. We studied the correlation between different ligation sites of the inferior mesenteric artery and curative effect. There were 20 patients (43%) in the high ligation group and 60 patients (41%) in the low ligation group with positive lymph nodes. There was no significant difference in survival between the two groups. However, the incidences of postoperative anastomotic complications and functional urinary complications were significantly lower in the L-L group. This study confirmed that preservation of the left colic artery should be recommended in the surgery.